Provider Demographics
NPI:1164896692
Name:LUNA THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:LUNA THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HATCHETT
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:480-907-9119
Mailing Address - Street 1:2705 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4400
Mailing Address - Country:US
Mailing Address - Phone:480-907-9119
Mailing Address - Fax:877-684-3045
Practice Address - Street 1:2705 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-4400
Practice Address - Country:US
Practice Address - Phone:480-907-9119
Practice Address - Fax:877-684-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5837225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty