| NPI | 1164836870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA RUSSELL Owner 808-553-5199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: HI AT-212) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2014-06-20 |