Provider Demographics
NPI:1134452519
Name:FONG-REYES, DANA LYNN (DPT, CSCS, TPI CGFI)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:LYNN
Last Name:FONG-REYES
Suffix:
Gender:F
Credentials:DPT, CSCS, TPI CGFI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 FARRINGTON HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-2028
Mailing Address - Country:US
Mailing Address - Phone:808-674-1142
Mailing Address - Fax:808-674-1143
Practice Address - Street 1:599 FARRINGTON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-2028
Practice Address - Country:US
Practice Address - Phone:808-674-1142
Practice Address - Fax:808-674-1143
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-31232251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic