Organization
PROFESSIONAL REHAB THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN I. CLARK (OWNER/THERAPIST)
(808) 671-7414
Entity
Organization
Contact information
Practice address
94-229 WAIPAHU DEPOT ST STE 301, WAIPAHU, HI 96797-3033
(808) 671-7414
(808) 671-7133
Mailing address
94-229 WAIPAHU DEPOT ST STE 301, WAIPAHU, HI 96797-3033
(808) 671-7414
(808) 671-7133
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
HI
225700000X
Massage Therapist
MAT 8855
HI
Other
Enumeration date
02/27/2009
Last updated
02/27/2009
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