Healthcare Provider Details

I. General information

NPI: 1316627722
Provider Name (Legal Business Name): INDIANA LUNA CARE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MUNICIPAL DR STE 200
FISHERS IN
46038-1634
US

IV. Provider business mailing address

PO BOX 290609
NASHVILLE TN
37229-0609
US

V. Phone/Fax

Practice location:
  • Phone: 866-525-3175
  • Fax: 650-227-9115
Mailing address:
  • Phone: 866-525-3175
  • Fax: 650-227-9115

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
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LILY ANN BELTRAN
Title or Position: PRESIDENT
Credential:
Phone: 949-291-4421