MEDICARE: LUNA PELVIC HEALTH

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
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1154277614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUNA PELVIC HEALTH

Provider Business Mailing Address
First Line	:	46 OLD CHURCH RD
Second Line	:
City	:	EGG HARBOR CITY
State	:	NJ
Zip	:	08215-4734
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 OLD CHURCH RD
Second Line	:
City	:	EGG HARBOR CITY
State	:	NJ
Zip	:	08215-4734
Country	:	US
Telephone Number	:	609-432-6622
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRITTANY CLARK
Credential	:	PT, DPT
Telephone Number	:	609-432-6622

Provider Enumeration Date	:	03/07/2026
Last Update Date	:	03/07/2026

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