Organization
PHYSICAL THERAPY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN T. LEE D.P.T. (CO-OWNER)
(808) 596-9446
Entity
Organization
Contact information
Practice address
770 KAPIOLANI BLVD, SUITE 104, HONOLULU, HI 96813-5212
(808) 596-9446
(808) 596-9160
Mailing address
770 KAPIOLANI BLVD, SUITE 104, HONOLULU, HI 96813-5212
(808) 596-9446
(808) 596-9160
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
W40062604-01
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209006700
OWCP PROVIDER NUMBER
HI
01
—
Z1654
MDX PROVIDER NUMBER
HI
Enumeration date
02/13/2007
Last updated
12/06/2012
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