Provider Demographics
NPI:1780850479
Name:SEA TO SKY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SEA TO SKY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-280-0229
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-3046
Mailing Address - Country:US
Mailing Address - Phone:808-280-0229
Mailing Address - Fax:808-244-4100
Practice Address - Street 1:84 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1725
Practice Address - Country:US
Practice Address - Phone:808-280-0229
Practice Address - Fax:808-244-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH101432Medicare PIN