Luther Agdaca

Individual provider Active NPI Physical Therapist · Simpsonville, SC

NPI 1255879862 · NPPES record last updated Feb 2, 2017

Key facts

NPI
1255879862
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
6 Felhurst CT
Simpsonville, SC 29681-6546
Phone
(864) 412-8901
NPI assigned
Feb 2, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Total Therapy Services Physical Therapist Current
since Jul 25, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

6 Felhurst CT
Simpsonville, SC 29681-6546

Mailing address

6 Felhurst CT
Simpsonville, SC 29681-6546
Phone (864) 412-8901

Other providers in Simpsonville, SC

All providers in Simpsonville, SC · Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.