Provider Demographics
NPI:1609048214
Name:UPPER ROOM PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:UPPER ROOM PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:TH
Authorized Official - Last Name:CHOY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:808-398-8076
Mailing Address - Street 1:1451 S KING ST
Mailing Address - Street 2:SUITE 506
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2506
Mailing Address - Country:US
Mailing Address - Phone:808-398-8076
Mailing Address - Fax:808-955-5580
Practice Address - Street 1:1451 S KING ST
Practice Address - Street 2:SUITE 506
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2506
Practice Address - Country:US
Practice Address - Phone:808-398-8076
Practice Address - Fax:808-955-5580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1094261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy