Healthcare Provider Details

I. General information

NPI: 1427638832
Provider Name (Legal Business Name): DC LUNA CARE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CONNECTICUT AVE NW
WASHINGTON DC
20036-4303
US

IV. Provider business mailing address

PO BOX 290609
NASHVILLE TN
37229-0609
US

V. Phone/Fax

Practice location:
  • Phone: 866-806-3599
  • Fax: 833-817-7128
Mailing address:
  • Phone: 866-525-3175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JASMINE GONZALEZ
Title or Position: PAYER OPERATIONS SUPERVISOR
Credential:
Phone: 916-232-3047