Provider Demographics
NPI:1457023756
Name:HARDY AND LUKES PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:HARDY AND LUKES PHYSICAL THERAPY, INC.
Other - Org Name:HEALTHPRO PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP OUTPATIENT PEDIATRICS
Authorized Official - Prefix:
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:303-437-4364
Mailing Address - Street 1:41769 ENTERPRISE CIR N STE 104-105
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-5626
Mailing Address - Country:US
Mailing Address - Phone:951-303-8255
Mailing Address - Fax:
Practice Address - Street 1:2445 TRUXTUN RD STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-6154
Practice Address - Country:US
Practice Address - Phone:619-501-9755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty