Provider Demographics
NPI:1023536976
Name:GUERRERO-DAR, KRIS DIANNE (PT)
Entity Type:Individual
Prefix:
First Name:KRIS DIANNE
Middle Name:
Last Name:GUERRERO-DAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 970068
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-0068
Mailing Address - Country:US
Mailing Address - Phone:808-600-9148
Mailing Address - Fax:800-942-7053
Practice Address - Street 1:94-216 FARRINGTON HWY STE A-102
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797
Practice Address - Country:US
Practice Address - Phone:808-600-9148
Practice Address - Fax:800-942-7053
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT4341225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist