Provider Demographics
NPI:1033610795
Name:TRIUMPH THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:TRIUMPH THERAPY SERVICES, LLC
Other - Org Name:MAKAKILO PHYSICAL THERAPY AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-383-6442
Mailing Address - Street 1:91-1019 WAIKAI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6421
Mailing Address - Country:US
Mailing Address - Phone:808-782-5379
Mailing Address - Fax:808-744-6932
Practice Address - Street 1:91-1019 WAIKAI ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-6421
Practice Address - Country:US
Practice Address - Phone:808-782-5379
Practice Address - Fax:808-744-6932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty