Provider Demographics
NPI:1548378979
Name:BACK IN ACTION, INC,
Entity Type:Organization
Organization Name:BACK IN ACTION, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BILANCIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-284-6550
Mailing Address - Street 1:755 KAIPII ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2033
Mailing Address - Country:US
Mailing Address - Phone:808-284-6550
Mailing Address - Fax:
Practice Address - Street 1:755 KAIPII ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2033
Practice Address - Country:US
Practice Address - Phone:808-284-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2007261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy