Individual
MRS. AVIS S KANESHIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2228 LILIHA STREET, STE 407, HONOLULU, HI 96817-1654
(808) 255-1200
(808) 748-0110
Mailing address
PO BOX 3264, HONOLULU, HI 96801-3264
(808) 533-2275
(808) 533-1275
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT 810
HI
225100000X
Physical Therapist
Primary
PT810
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BG546Y
MEDICARE PTAN
HI
Enumeration date
05/21/2008
Last updated
03/29/2019
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