Provider Demographics
NPI:1306378468
Name:LUKE THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:LUKE THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENAE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:MHS-CCC-SLP
Authorized Official - Phone:660-853-8593
Mailing Address - Street 1:200 N DEWEY STREET
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-8323
Mailing Address - Country:US
Mailing Address - Phone:660-853-8593
Mailing Address - Fax:
Practice Address - Street 1:200 N DEWEY STREET
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-8323
Practice Address - Country:US
Practice Address - Phone:660-853-8593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech