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NPI Code Detail

MEDICARE: WISCONSIN LUNA CARE PHYSICAL THERAPY LLC

MEDICARE: WISCONSIN 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
1235Z00000XSpeech-Language Pathologist
2225X00000XOccupational Therapist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1518576164
Entity Type Code : Organization
Provider Name (Legal Business Name) : WISCONSIN LUNA CARE PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : PO BOX 290609
Second Line :
City : NASHVILLE
State : TN
Zip : 37229-0609
Country : US
Telephone Number : 866-525-3175
Fax Number :
Provider Business Practice Location Address
First Line : 525 JUNCTION RD STE 6500
Second Line :
City : MADISON
State : WI
Zip : 53717-2153
Country : US
Telephone Number : 877-839-6979
Fax Number :
Authorized Official
Title or Position : PAYER OPERATIONS SUPERVISOR
Name : JASMINE GONZALEZ
Credential :
Telephone Number : 916-232-3047
Provider Enumeration Date : 07/29/2020
Last Update Date : 02/06/2026

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Directions to “WISCONSIN LUNA CARE PHYSICAL THERAPY LLC ” Practice Location

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