Provider Demographics
NPI:1972862399
Name:HEUSEL, LUKE DOUGLAS (DPT)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:DOUGLAS
Last Name:HEUSEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 DANTIGNAC ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2774
Mailing Address - Country:US
Mailing Address - Phone:706-922-6555
Mailing Address - Fax:706-823-3810
Practice Address - Street 1:1305 DANTIGNAC ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2774
Practice Address - Country:US
Practice Address - Phone:706-922-6555
Practice Address - Fax:706-823-3810
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist