Organization
MIND DOOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE LUC PT, DPT (OWNER)
(314) 504-2457
Entity
Organization
Contact information
Practice address
7401 W HOOD PL STE 210, KENNEWICK, WA 99336-3400
(509) 557-0373
Mailing address
7401 W HOOD PL STE 210, KENNEWICK, WA 99336-3400
(509) 557-0373
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
2251N0400X
Neurology Physical Therapist
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
01/27/2021
Last updated
02/24/2022
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