Provider Demographics
NPI:1942629241
Name:MANA PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:MANA PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:SORIANO
Authorized Official - Last Name:CAMACAYLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-885-7131
Mailing Address - Street 1:68-1845 WAIKOLOA RD
Mailing Address - Street 2:SUITE 106 # 220
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738
Mailing Address - Country:US
Mailing Address - Phone:808-883-3400
Mailing Address - Fax:808-883-3440
Practice Address - Street 1:68-1845 WAIKOLOA RD
Practice Address - Street 2:SUITE 211
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738
Practice Address - Country:US
Practice Address - Phone:808-883-3400
Practice Address - Fax:808-883-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty