Organization
LUNARA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN JOSEPH NICHOLS PT, DPT, FAAOMPT (SHAREHOLDER)
(267) 777-9878
Entity
Organization
Contact information
Practice address
5 PARK AVE, ORELAND, PA 19075-1314
(267) 777-9878
Mailing address
5 PARK AVE, ORELAND, PA 19075-1314
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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