| Organization Name: | JACO REHAB WAIKELE LLC |
| NPI Number: | 1811327059 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACO J VAN DELDEN (OWNER) |
| Mailing Address: | 94-849 Lumiaina St Suite 101 Waipahu |
| State: | HI US |
| Postal Code: | 967975677 |
| Phone Number: | 8085368947 |
| Fax Number: | 8085912245 |
| NPI Enumeration Date: | 11/26/2013 |
| NPI Last Update Date: | 11/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-1582 |
| 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 |