Organization
TOTAL FITNESS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL KIYOSHI YAMADA PT (PRESIDENT)
(808) 536-6117
Entity
Organization
Contact information
Practice address
1650 LILIHA ST, #107, HONOLULU, HI 96817
(808) 536-6117
(808) 587-7727
Mailing address
1650 LILIHA ST, #107, HONOLULU, HI 96817
(808) 536-6117
(808) 587-7727
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
857
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A080760
HMSA
HI
05
—
A9315601
—
HI
Enumeration date
06/01/2006
Last updated
08/22/2020
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