Provider Demographics
NPI:1548614126
Name:SHINSATO, JOHN (LMT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SHINSATO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-162 NEEPU PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-5307
Mailing Address - Country:US
Mailing Address - Phone:808-226-7856
Mailing Address - Fax:
Practice Address - Street 1:45-162 NEEPU PL
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-5307
Practice Address - Country:US
Practice Address - Phone:808-226-7856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-12754172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist