Individual
MR. THERON OGATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
75-5699 KOPIKO ST, KAILUA KONA, HI 96740-1668
(808) 329-7744
Mailing address
75-5699 KOPIKO ST, KAILUA KONA, HI 96740-1668
(808) 329-7744
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-1906
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
572265-02
—
HI
Enumeration date
02/14/2007
Last updated
02/08/2008
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