Individual
BROCK A. CHARLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
161 WAILEA IKE PL STE A105, KIHEI, HI 96753-6502
(808) 661-5266
(808) 661-5264
Mailing address
PO BOX 215, KIHEI, HI 96753-0215
(808) 661-5266
(808) 661-5264
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2676
HI
Other
Enumeration date
09/25/2006
Last updated
09/18/2024
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