Provider Demographics
NPI:1932648284
Name:KALO PHYSICAL THERAPY MULTISPECIALITY GROUP LLC
Entity Type:Organization
Organization Name:KALO PHYSICAL THERAPY MULTISPECIALITY GROUP LLC
Other - Org Name:KPTMG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-987-6795
Mailing Address - Street 1:PO BOX 5235
Mailing Address - Street 2:APT J3
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-5235
Mailing Address - Country:US
Mailing Address - Phone:808-987-6795
Mailing Address - Fax:
Practice Address - Street 1:75-5597 PALANI RD STE A1
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1661
Practice Address - Country:US
Practice Address - Phone:808-987-6795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-32682251G0304X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPT-3268OtherDCCA STATE LICENSING AGENCY IN HAWAII