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NPI Code Detail

MEDICARE: NORTH CAROLINA LUNA CARE PHYSICAL THERAPY LLC

MEDICARE: NORTH CAROLINA LUNA CARE PHYSICAL THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1124626148
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH CAROLINA LUNA CARE PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : PO BOX 2350
Second Line :
City : ROCKLIN
State : CA
Zip : 95677-8350
Country : US
Telephone Number : 866-806-3599
Fax Number : 833-817-7128
Provider Business Practice Location Address
First Line : 445 MAPLE ST
Second Line :
City : PALO ALTO
State : CA
Zip : 94301-2219
Country : US
Telephone Number : 866-806-3599
Fax Number : 833-817-7128
Authorized Official
Title or Position : PAYER DIRECTOR
Name : CLARISA ODELL
Credential :
Telephone Number : 650-867-0522
Provider Enumeration Date : 10/12/2020
Last Update Date : 04/01/2021

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Directions to “NORTH CAROLINA LUNA CARE PHYSICAL THERAPY LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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