Provider Demographics
NPI:1255382347
Name:MOSES, JAMES COLE (RPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:COLE
Last Name:MOSES
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 ALA WAI BLVD
Mailing Address - Street 2:APT 802
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-5111
Mailing Address - Country:US
Mailing Address - Phone:888-561-0023
Mailing Address - Fax:888-561-0023
Practice Address - Street 1:2029 ALA WAI BLVD
Practice Address - Street 2:APT 802
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-5111
Practice Address - Country:US
Practice Address - Phone:888-561-0023
Practice Address - Fax:888-561-0023
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI2384OtherPHYSICAL THERAPY LICENSE