Provider Demographics
NPI:1437645181
Name:KEIKI THERAPY LLC
Entity Type:Organization
Organization Name:KEIKI THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KORANDA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:808-209-7934
Mailing Address - Street 1:68-1849 PAU NANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5441
Mailing Address - Country:US
Mailing Address - Phone:808-747-4982
Mailing Address - Fax:
Practice Address - Street 1:64-957 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8415
Practice Address - Country:US
Practice Address - Phone:808-209-7934
Practice Address - Fax:808-883-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-05
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI992225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty