Organization
SOUTH SHORE PHYSICAL THERAPY & SPORTSMEDICINE, INC
Active
Other names
Imua Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY G PRANGNELL P.T. (OWNER/PRES)
(808) 879-0077
Entity
Organization
Contact information
Practice address
411 HUKU LII PL STE 101, KIHEI, HI 96753
(808) 298-4933
(808) 879-0177
Mailing address
411 HUKU LII PL,. STE 101, KIHEI, HI 96753
(808) 879-0077
(808) 879-0177
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/18/2006
Last updated
10/15/2020
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