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General NPI Number Information
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NPI Number | 1003448994
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Entity Type | Organization
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Legal Business Name | MICHIGAN LUNA CARE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/07/2020
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 206 S 5TH AVE STE 550
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City | ANN ARBOR
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State | MI
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Zip | 48104-2268
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Country | US
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Telephone | 866-839-6979
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 290609
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City | NASHVILLE
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State | TN
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Zip | 37229-0609
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Country | US
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Telephone | 866-525-3175
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Fax |
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Authorized Official
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Title or Position | PAYER OPERATIONS SUPERVISOR
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Name | JASMINE GONZALEZ
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Credential |
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Telephone | 916-232-3047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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