MEDICARE: L&L THERAPY SERVICES, 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
1	235Z00000X	Speech-Language Pathologist		NC

General Provider Information

NPI Number	:	1316272644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L&L THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	4045 AMBER LEIGH WAY DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-2374
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	543 COX RD
Second Line	:	SUITE B1
City	:	GASTONIA
State	:	NC
Zip	:	28054-0607
Country	:	US
Telephone Number	:	704-609-4647
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW LEWIS
Credential	:
Telephone Number	:	704-609-5336

Provider Enumeration Date	:	10/05/2009
Last Update Date	:	10/05/2009

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Directions to “L&L THERAPY SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

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