Provider Demographics
NPI:1427195924
Name:GILLIS, VALERIE ROBIN (PT)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ROBIN
Last Name:GILLIS
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 1:75-217 NANI KAILUA DR
Mailing Address - Street 2:#134
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-2051
Mailing Address - Country:US
Mailing Address - Phone:808-329-8460
Mailing Address - Fax:
Practice Address - Street 1:78-6957 KAMEHAMEHA III RD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2528
Practice Address - Country:US
Practice Address - Phone:808-322-2790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist