Provider Demographics
NPI:1356789606
Name:LUFFMAN, CASEY LEIGH (PTA)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:LEIGH
Last Name:LUFFMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:CASEY
Other - Middle Name:LEIGH
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2905 SWAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28642-9440
Mailing Address - Country:US
Mailing Address - Phone:336-258-2300
Mailing Address - Fax:
Practice Address - Street 1:142 BERMUDA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-7867
Practice Address - Country:US
Practice Address - Phone:336-940-6433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5055225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant