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NPI Code Detail

MEDICARE: GEORGIA LUNA CARE PHYSICAL THERAPY LLC

MEDICARE: GEORGIA LUNA CARE PHYSICAL THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist
2225X00000XOccupational Therapist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1245826999
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEORGIA LUNA CARE PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : PO BOX 290609
Second Line :
City : NASHVILLE
State : TN
Zip : 37229-0609
Country : US
Telephone Number : 866-525-3175
Fax Number :
Provider Business Practice Location Address
First Line : 504 EVERETT ST
Second Line :
City : ST SIMONS IS
State : GA
Zip : 31522-4605
Country : US
Telephone Number : 877-839-6979
Fax Number :
Authorized Official
Title or Position : PAYER OPERATIONS SUPERVISOR
Name : JASMINE GONZALEZ
Credential :
Telephone Number : 916-232-3047
Provider Enumeration Date : 12/16/2020
Last Update Date : 02/06/2026

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Directions to “GEORGIA LUNA CARE PHYSICAL THERAPY LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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