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Individual

DR. MICHAEL ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
81 MAKAWAO AVE STE 110, MAKAWAO, HI 96768-8859
(808) 572-2281
(808) 573-5869
Mailing address
81 MAKAWAO AVE, STE 110, MAKAWAO, HI 96768-8859
(808) 572-2281
(808) 573-5869

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5176
HI
225100000X
Physical Therapist
PT292198
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13804495
CAQH
Enumeration date
04/04/2014
Last updated
07/27/2021
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