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General NPI Number Information
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NPI Number | 1750900387
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Entity Type | Individual
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Provider Name | AURIEL LUNA PTA
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Gender | Male
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 2701 PRAIRIE MEADOW DR
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City | IOWA CITY
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State | IA
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Zip | 52242-8001
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Country | US
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Telephone | 319-384-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 CLIMER ST
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City | MUSCATINE
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State | IA
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Zip | 52761-2505
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Country | US
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Telephone | 563-506-2835
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 001403
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License Number State | IA
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