Provider Demographics
NPI:1891332771
Name:AULD, JOSHUA ALIIMEAHEENALU (ATC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ALIIMEAHEENALU
Last Name:AULD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 KUOKOA ST
Mailing Address - Street 2:
Mailing Address - City:PEARL CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96782-1954
Mailing Address - Country:US
Mailing Address - Phone:808-554-0708
Mailing Address - Fax:
Practice Address - Street 1:1887 MAKUAKANE ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1800
Practice Address - Country:US
Practice Address - Phone:808-554-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-10
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI20000370932255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer