Individual
LUKE BANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5535 S WILLIAMSON BLVD, SUITE 774, PORT ORANGE, FL 32128-8311
(888) 265-2680
Mailing address
496 1ST ST, CONEMAUGH, PA 15909-1908
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
48894
CA
225200000X
Physical Therapy Assistant
TE009934
PA
Other
Enumeration date
09/19/2016
Last updated
07/19/2019
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