| Enchanted Lake Physical Therapy | |
|
1090 Keolu Dr, Suite 104, Kailua, HI 96734-3871 | |
| (808) 262-2292 | |
| Not Available |
| Full Name | Enchanted Lake Physical Therapy |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 1090 Keolu Dr, Kailua, Hawaii |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942598883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Mark K Iwasaki |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285688408 PECOS PAC ID: 7719907468 Enrollment ID: I20051128000334 |
| Provider Name | Justin A Rietfors |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457455479 PECOS PAC ID: 3375559511 Enrollment ID: I20060227000161 |
| Provider Name | Everett R Wong |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679520985 PECOS PAC ID: 2860481058 Enrollment ID: I20060823000100 |
| Provider Name | Todd K A Clark |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790850758 PECOS PAC ID: 4082878715 Enrollment ID: I20120611000098 |
| Provider Name | Jasmine A Monahan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891407847 PECOS PAC ID: 5193197382 Enrollment ID: I20230216002269 |
| Mailing Address | Practice Location Address |
|---|---|
| Enchanted Lake Physical Therapy Po Box 1440, Kailua, HI 96734-1440 Ph: () - | Enchanted Lake Physical Therapy 1090 Keolu Dr, Suite 104, Kailua, HI 96734-3871 Ph: (808) 262-2292 |
Michael W Rufino, RPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 30 Aulike St, Kailua Professional Center, Suite 201, Kailua, HI 96734 Phone: 808-230-2359 Fax: 808-230-2375 | |
Dr. Jill Dietmeyer, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 602 Kailua Rd, #202, Kailua, HI 96734 Phone: 808-263-0343 | |
Mrs. Christina M Gallagher, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 122 Oneawa St, Kailua, HI 96734 Phone: 808-263-4263 | |
Mrs. Julie A Hess, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 970 N Kalaheo Ave Ste C316, Kailua, HI 96734 Phone: 808-488-5555 | |
Jason Edward Lau, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 407 Uluniu St Ste 301, Kailua, HI 96734 Phone: 808-261-4321 | |
Andrea M. Taylor, MS,PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 354 Kaelepulu Dr Apt D, Kailua, HI 96734 Phone: 808-277-6167 Fax: 808-261-6440 | |
Three Paths Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 130 Kailua Rd, 107, Kailua, HI 96734 Phone: 808-779-8475 Fax: 808-394-8702 |