Provider Demographics
NPI:1780736926
Name:CSPT LLC
Entity type:Organization
Organization Name:CSPT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:COTTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-823-9300
Mailing Address - Street 1:4-1558 KUHIO HWY
Mailing Address - Street 2:STE 4
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-1856
Mailing Address - Country:US
Mailing Address - Phone:808-823-9300
Mailing Address - Fax:808-823-9392
Practice Address - Street 1:4-1558 KUHIO HWY
Practice Address - Street 2:STE 4
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1856
Practice Address - Country:US
Practice Address - Phone:808-823-9300
Practice Address - Fax:808-823-9392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty