Provider Demographics
NPI:1548502651
Name:MAUI NATURAL MEDICINE & PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MAUI NATURAL MEDICINE & PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:FRANGOS
Authorized Official - Suffix:
Authorized Official - Credentials:ND & P T
Authorized Official - Phone:808-891-1111
Mailing Address - Street 1:1215 S KIHEI RD
Mailing Address - Street 2:STE O BOX 707
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-5220
Mailing Address - Country:US
Mailing Address - Phone:808-891-1111
Mailing Address - Fax:808-442-9938
Practice Address - Street 1:1325 S KIHEI ROAD
Practice Address - Street 2:STE 102C
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8145
Practice Address - Country:US
Practice Address - Phone:808-891-1111
Practice Address - Fax:808-442-9938
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIM BAUSKE & ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI32182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty