Provider Demographics
NPI:1790918266
Name:BODYPRO OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:BODYPRO OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KANIHO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:808-887-1371
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-0063
Mailing Address - Country:US
Mailing Address - Phone:808-887-1371
Mailing Address - Fax:
Practice Address - Street 1:64-974 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-7334
Practice Address - Country:US
Practice Address - Phone:808-887-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI252174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty