Provider Demographics
NPI:1891032330
Name:ARAKAKI PHYSICAL THERAPY AND SPORTS REHABILITATION, INC.
Entity Type:Organization
Organization Name:ARAKAKI PHYSICAL THERAPY AND SPORTS REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKAKI
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:808-969-3827
Mailing Address - Street 1:182 MOHOULI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3953
Mailing Address - Country:US
Mailing Address - Phone:808-969-3827
Mailing Address - Fax:
Practice Address - Street 1:182 MOHOULI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3953
Practice Address - Country:US
Practice Address - Phone:808-969-3827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI05578-0OtherHMSA
HI0000CBBMZMedicare UPIN