Provider Demographics
NPI: | 1578729356 |
---|---|
Name: | HARDY AND LUKES PHYSICAL THERAPY, INC. |
Entity type: | Organization |
Organization Name: | HARDY AND LUKES PHYSICAL THERAPY, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | SVP OUTPATIENT PEDIATRICS |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TERRA |
Authorized Official - Middle Name: | RAE |
Authorized Official - Last Name: | SCOTT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSPT |
Authorized Official - Phone: | 303-437-4364 |
Mailing Address - Street 1: | 41769 ENTERPRISE CIR N STE 104-105 |
Mailing Address - Street 2: | |
Mailing Address - City: | TEMECULA |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92590-5626 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 951-303-8255 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 41769 ENTERPRISE CIR N STE 104-105 |
Practice Address - Street 2: | |
Practice Address - City: | TEMECULA |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92590-5626 |
Practice Address - Country: | US |
Practice Address - Phone: | 951-303-8255 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-08-01 |
Last Update Date: | 2023-06-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |