Provider Demographics
NPI:1508205402
Name:THERAPEUTIC CONCEPTS, LLC
Entity type:Organization
Organization Name:THERAPEUTIC CONCEPTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNENHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-348-7747
Mailing Address - Street 1:1714 ANAPUNI ST
Mailing Address - Street 2:301
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-4482
Mailing Address - Country:US
Mailing Address - Phone:808-348-7747
Mailing Address - Fax:808-356-0888
Practice Address - Street 1:1714 ANAPUNI ST
Practice Address - Street 2:301
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-4482
Practice Address - Country:US
Practice Address - Phone:808-348-7747
Practice Address - Fax:808-356-0888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2468261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy