Provider Demographics
NPI:1225097504
Name:MANSOUR, RHEAM (PT)
Entity Type:Individual
Prefix:MISS
First Name:RHEAM
Middle Name:
Last Name:MANSOUR
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 969
Mailing Address - Street 2:
Mailing Address - City:PAHOA
Mailing Address - State:HI
Mailing Address - Zip Code:96778-0969
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:944 W KAWAILANI STREET
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HAWAII
Practice Address - Zip Code:96778
Practice Address - Country:UM
Practice Address - Phone:808-959-9151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-3601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist