Provider Demographics
NPI:1477145001
Name:CLEGHORN, ELIZABETH K (DPT, PT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:CLEGHORN
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:K
Other - Last Name:SAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 S BERETANIA ST STE 550
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1880
Mailing Address - Country:US
Mailing Address - Phone:808-381-8947
Mailing Address - Fax:
Practice Address - Street 1:1401 S BERETANIA ST STE 550
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1880
Practice Address - Country:US
Practice Address - Phone:808-381-8947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-5117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist