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NPI Code Detail

MEDICARE: MICHAEL A. LUSK P.T.

MEDICARE: MICHAEL A. LUSK P.T.
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
1225100000XPhysical Therapist002408WV
2225100000XPhysical Therapist004114KY
3225100000XPhysical TherapistPT 009744OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982686127
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL A. LUSK P.T.
Provider Business Mailing Address
First Line : 2010 MAN O WAR DR
Second Line :
City : RACELAND
State : KY
Zip : 41169
Country : US
Telephone Number : 606-571-6207
Fax Number :
Provider Business Practice Location Address
First Line : 10098 BEAR CREEK RD
Second Line :
City : LUCASVILLE
State : OH
Zip : 45648-9168
Country : US
Telephone Number : 740-259-5536
Fax Number : 740-259-2531
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 02/07/2013

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