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Organization

HAWAII'S IMPAC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA TAYLOR MS,PT (OWNER)
(808) 277-6167
Entity
Organization

Contact information

Practice address
354 KAELEPULU DR APT D, KAILUA, HI 96734-3355
(808) 277-6167
(808) 261-6440
Mailing address
354 KAELEPULU DR APT D, KAILUA, HI 96734-3355
(808) 277-6167
(808) 261-6440

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
895
HI

Other

Enumeration date
01/16/2009
Last updated
01/16/2009
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