Organization
PHYSICAL THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIRSTEN JEGSEN MELCHER PT (OWNER AND PHYSICAL THERAPIST)
(808) 373-4787
Entity
Organization
Contact information
Practice address
850 W HIND DR, SUITE 104 AND 108, HONOLULU, HI 96821-1855
(808) 373-4787
Mailing address
850 W HIND DR, SUITE 104 AND 108, HONOLULU, HI 96821-1855
(808) 373-4787
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B5797-2
HMSA 65C PLUS GROUP
HI
01
—
DA8455
MEDICARE RAILROAD
HI
01
—
Z1610
MDX HAWAII NETWORK GROUP
HI
Enumeration date
12/01/2006
Last updated
08/22/2020
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