Provider Demographics
NPI:1093232514
Name:O'LUA THERAPY LLC
Entity Type:Organization
Organization Name:O'LUA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:OREGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:623-349-2060
Mailing Address - Street 1:9524 W CAMELBACK RD
Mailing Address - Street 2:STE. C-130 PMB 232
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305
Mailing Address - Country:US
Mailing Address - Phone:623-349-2060
Mailing Address - Fax:
Practice Address - Street 1:9524 W CAMELBACK RD
Practice Address - Street 2:STE. C-130 PMB 232
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85305
Practice Address - Country:US
Practice Address - Phone:623-349-2060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty