| Doctor Name: | MRS. CAROL ANN IADELUCA-MYRIANTHIS |
| NPI Number: | 1477565745 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, PSYD |
| License Number: | 474 |
| Business Practice Address: | 15-2866 Government Main Road Pahoa Village Center Pahoa, HI - 96778 |
| Business Phone Number: | 8089650880 |
| Business Fax Number: | 8089650770 |
| Mailing Address: | 339 Alawaena St, HILO |
| State: | HI |
| Postal Code: | 967203506 |
| Phone Number: | 8089590877 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2006 |
| NPI Last Update Date: | 05/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 474 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |