Provider Demographics
NPI:1245831718
Name:MANIBO, ALBERT FRANCIS MARABILLO (PTA)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:FRANCIS MARABILLO
Last Name:MANIBO
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1388 MOANIANI ST STE 243
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-6606
Mailing Address - Country:US
Mailing Address - Phone:808-744-5161
Mailing Address - Fax:808-744-6639
Practice Address - Street 1:94-1388 MOANIANI ST STE 243
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-6606
Practice Address - Country:US
Practice Address - Phone:808-744-5161
Practice Address - Fax:808-744-6639
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPTA391225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant