Provider Demographics
NPI:1710466867
Name:HILL, FUNMILAYO M (DPT)
Entity Type:Individual
Prefix:
First Name:FUNMILAYO
Middle Name:M
Last Name:HILL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:FUNMILAYO
Other - Middle Name:M
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FUMI
Mailing Address - Street 1:338 KAMOKILA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2055
Mailing Address - Country:US
Mailing Address - Phone:808-674-9998
Mailing Address - Fax:
Practice Address - Street 1:338 KAMOKILA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2055
Practice Address - Country:US
Practice Address - Phone:808-674-9998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4806225100000X
VA2305212266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist