Provider Demographics
NPI:1144320615
Name:MILTON ORTHOPAEDIC & SPORTS PHYSICAL THERAPY
Entity type:Organization
Organization Name:MILTON ORTHOPAEDIC & SPORTS PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-796-3221
Mailing Address - Street 1:54-396 UNION MILL RD UNIT 1179
Mailing Address - Street 2:
Mailing Address - City:KAPAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96755-3050
Mailing Address - Country:US
Mailing Address - Phone:808-796-3221
Mailing Address - Fax:
Practice Address - Street 1:55-3435 AKONI PULE HWY
Practice Address - Street 2:#7
Practice Address - City:HAWI
Practice Address - State:HI
Practice Address - Zip Code:96719-9671
Practice Address - Country:US
Practice Address - Phone:808-796-3221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy