Provider Demographics
NPI:1740488006
Name:STAYFIT PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:STAYFIT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KOIKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-674-0500
Mailing Address - Street 1:95-199 HOAHELE PLACE
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-5544
Mailing Address - Country:US
Mailing Address - Phone:808-674-0500
Mailing Address - Fax:808-674-0511
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:#207
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3925
Practice Address - Country:US
Practice Address - Phone:808-487-0487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1121261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy