| Organization Name: | KAILUA PHYSICAL THERAPY CLINIC, INC |
| NPI Number: | 1003004896 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANET S. BARRETTA (OWNER/PRESIDENT) |
| Mailing Address: | 155 Hamakua Dr Suite B Kailua |
| State: | HI US |
| Postal Code: | 967342849 |
| Phone Number: | 8082618931 |
| Fax Number: | 8082610301 |
| NPI Enumeration Date: | 10/05/2007 |
| NPI Last Update Date: | 10/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 662 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |