Provider Demographics
NPI:1457361081
Name:PEETERS, LITA GOSOCO (PT)
Entity type:Individual
Prefix:
First Name:LITA
Middle Name:GOSOCO
Last Name:PEETERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ESTRELLITA
Other - Middle Name:DAGAMI
Other - Last Name:GO-SOCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1221 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 6E
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3503
Mailing Address - Country:US
Mailing Address - Phone:808-447-7488
Mailing Address - Fax:808-593-2275
Practice Address - Street 1:1221 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 6E
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3503
Practice Address - Country:US
Practice Address - Phone:808-447-7488
Practice Address - Fax:808-593-2275
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist