Provider Demographics
NPI:1184770570
Name:PRO CARE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:PRO CARE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORNA-PATRIA
Authorized Official - Middle Name:CALUPIG
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-847-2644
Mailing Address - Street 1:2024 N KING ST STE 109
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3470
Mailing Address - Country:US
Mailing Address - Phone:808-847-2644
Mailing Address - Fax:808-847-2624
Practice Address - Street 1:2024 N KING ST STE 109
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3470
Practice Address - Country:US
Practice Address - Phone:808-847-2644
Practice Address - Fax:808-847-2624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT1903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty