Organization
LAHAINA PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BROCK A. CHARLESTON DPT (OWNER , MANAGER)
(808) 661-5266
Entity
Organization
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
261QP2000X
Physical Therapy Clinic/Center
Primary
2676
HI
Other
Enumeration date
06/27/2008
Last updated
04/29/2024
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