Provider Demographics
NPI:1346262888
Name:WARNEKE, JOHN ALLEN (PT, CSCS, C PED)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALLEN
Last Name:WARNEKE
Suffix:
Gender:M
Credentials:PT, CSCS, C PED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:68-1694 NANALA CT
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5549
Mailing Address - Country:US
Mailing Address - Phone:808-494-0197
Mailing Address - Fax:808-887-1373
Practice Address - Street 1:64-974 MAMALAHOA HWY STE 103
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-887-1371
Practice Address - Fax:808-887-1373
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 2646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist