Provider Demographics
NPI:1770678252
Name:SLR THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:SLR THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DAMIEN
Authorized Official - Last Name:MAKIYA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-732-4288
Mailing Address - Street 1:820 MILILANI STREET SUITE 702A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813
Mailing Address - Country:US
Mailing Address - Phone:808-523-9363
Mailing Address - Fax:808-523-9418
Practice Address - Street 1:4603 ALIIKOA STREET
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821
Practice Address - Country:US
Practice Address - Phone:808-732-4288
Practice Address - Fax:808-732-4288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 1930225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH57282Medicare ID - Type Unspecified