Provider Demographics
NPI:1558843847
Name:INVICTUS REHAB & WELLNESS
Entity Type:Organization
Organization Name:INVICTUS REHAB & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LETTERII
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-778-6832
Mailing Address - Street 1:PO BOX 25685
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-0685
Mailing Address - Country:US
Mailing Address - Phone:808-778-6832
Mailing Address - Fax:808-356-0655
Practice Address - Street 1:725 KAPIOLANI BLVD STE C103
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-6027
Practice Address - Country:US
Practice Address - Phone:808-778-6832
Practice Address - Fax:808-356-0655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty