Provider Demographics
NPI:1659474971
Name:SETO, KYLE BLAIR (MPT, ATC)
Entity type:Individual
Prefix:MR
First Name:KYLE
Middle Name:BLAIR
Last Name:SETO
Suffix:
Gender:M
Credentials:MPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 HALEOLA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821
Mailing Address - Country:US
Mailing Address - Phone:808-292-1030
Mailing Address - Fax:
Practice Address - Street 1:405 N KUAKINI STREET
Practice Address - Street 2:SUITE 1101
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-536-3072
Practice Address - Fax:808-536-5082
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2161225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist