Provider Demographics
NPI:1396030110
Name:WOODWARD, DAVID K (DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:K
Last Name:WOODWARD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 ALA ALII ST APT 26
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-1883
Mailing Address - Country:US
Mailing Address - Phone:808-721-4057
Mailing Address - Fax:
Practice Address - Street 1:1350 S KING ST
Practice Address - Street 2:SUITE 303
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2009
Practice Address - Country:US
Practice Address - Phone:808-721-4057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-3381225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist