Provider Demographics
NPI:1295390300
Name:PURE MOTION PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:PURE MOTION PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:RANDON
Authorized Official - Last Name:GUERPO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:808-635-5026
Mailing Address - Street 1:PO BOX 662004
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-7004
Mailing Address - Country:US
Mailing Address - Phone:808-635-5026
Mailing Address - Fax:
Practice Address - Street 1:1427 HONO OHALA PL
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-8727
Practice Address - Country:US
Practice Address - Phone:808-635-5026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty