| Divine Lovala Kuja, | |
|
601 S Great Southwest Pkwy Ste 106, Grand Prairie, TX 75051-1057 | |
| (214) 412-2528 | |
| Not Available |
| Full Name | Divine Lovala Kuja |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 12 Years |
| Location | 601 S Great Southwest Pkwy Ste 106, Grand Prairie, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922650100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1236233 (Texas) | Primary |
| Provider Name | Summit Physical Therapy P A |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1740282052 PECOS PAC ID: 6507842747 Enrollment ID: O20040628000855 |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Lovala Kuja, 601 S Great Southwest Pkwy Ste 106, Grand Prairie, TX 75051-1057 Ph: (214) 412-2528 | Divine Lovala Kuja, 601 S Great Southwest Pkwy Ste 106, Grand Prairie, TX 75051-1057 Ph: (214) 412-2528 |
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