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General NPI Number Information
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NPI Number | 1972536084
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Entity Type | Organization
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Legal Business Name | LUMINA OF CAMPBELLSVILLE
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2020 HODGENVILLE RD
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-8466
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Country | US
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Telephone | 270-849-2312
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Fax | 270-849-2406
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Provider Business Mailing Address
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Address Line | 2020 HODGENVILLE RD
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-8466
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Country | US
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Telephone | 270-849-2312
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Fax | 270-849-2406
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | DANA DEYOUNG
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Credential |
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Telephone | 502-245-0767
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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 | 002216
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | R1581
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | R2779
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License Number State | KY
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