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General NPI Number Information
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NPI Number | 1154206977
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Entity Type | Individual
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Provider Name | CALEB JOSEPH LUSK
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Gender | Male
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 416 ROBERTSON BLVD
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City | WALTERBORO
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State | SC
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Zip | 29488-2952
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Country | US
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Telephone | 843-538-2055
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Fax |
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Provider Business Mailing Address
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Address Line | 2014 LANCASTER PL
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City | PIERRE
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State | SD
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Zip | 57501-4901
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Country | US
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Telephone | 605-222-1994
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 6183
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CPO51491T
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CPO48544T
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License Number State | SC
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