Provider Demographics
NPI:1205515087
Name:CORE PHYSICAL THERAPY OF MAUI
Entity type:Organization
Organization Name:CORE PHYSICAL THERAPY OF MAUI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:KN
Authorized Official - Last Name:KUROKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-269-7776
Mailing Address - Street 1:23 KEONELOA ST
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2445
Mailing Address - Country:US
Mailing Address - Phone:808-269-7776
Mailing Address - Fax:
Practice Address - Street 1:1817 WELLS ST
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2333
Practice Address - Country:US
Practice Address - Phone:808-757-4449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty