# SOUTH CAROLINA LUNA CARE PHYSICAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720828841
- **Authorized official:** KRISTOFFER DUGGAN (CEO)
- **Authorized official phone:** (866) 806-3599

## Contact information

- **Practice address:** 128 MILLPORT CIR STE 200, GREENVILLE, SC 29607-5573
- **Practice address phone:** (866) 806-3599
- **Practice address fax:** (833) 817-7128
- **Mailing address:** PO BOX 2350, ROCKLIN, CA 95677-8350
- **Mailing address phone:** (866) 806-3599
- **Mailing address fax:** (833) 817-7128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 05/28/2024
- **Last updated:** 05/28/2024