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Individual

NAOMI T MARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
1325 S KIHEI ROAD, SUITE 110, KIHEI, HI 96753-8145
(808) 874-6972
(808) 874-6973
Mailing address
1325 S KIHEI ROAD, SUITE 110, KIHEI, HI 96753-8145
(808) 874-6972
(808) 874-6973

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
60046
OR
225100000X
Physical Therapist
Primary
PT4305
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500651972
OR
01
P01270240
RR MEDICARE
Enumeration date
11/20/2012
Last updated
02/08/2017
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