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Individual

MR. NICOLAS MYRIANTHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
15-2866 GOVERNMENT MAIN ROAD, PAHOA VILLAGE CENTER, PAHOA, HI 96778
(808) 965-0880
(808) 965-0770
Mailing address
339 ALAWAENA ST, HILO, HI 96720-3506
(808) 959-0877

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
473
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01025101
HI
05
01025102
HI
01
A10635
HMSA MAIN
HI
01
D10639
HMSA PAHOA
HI
Enumeration date
08/13/2006
Last updated
05/23/2008
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