Roberta M Lucio, PT
Individual provider Active NPI Physical Therapist · Gwinner, ND
NPI 1720016017 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720016017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 947 (ND)
- Practice address
- 11 North Main St
Gwinner, ND 58040-0586 - Phone
- (701) 678-2244
- Fax
- (701) 678-2210
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 947 | ND | Yes |
Addresses
Primary practice location
11 North Main St
Gwinner, ND 58040-0586
Mailing address
11 North Main St
PO Box 586
Gwinner, ND 58040-0586
Phone (701) 678-2244
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51058 | Medicaid | ND |
Other providers in Gwinner, ND
- Debora Hegg
- Ronald D Jacobson
- Susan D Lee
- Charles A Long
- Ryan Richard Lorenz
- Mobilityplus Rehabilitation LTD
- Rebecca Nelson
- Christopher Michael Nenow
- Tara L Nogowski
- Praise Okeadu
All providers in Gwinner, ND · Physical Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.