Madison Lee Luttrell

NPI #1114696747 in Portales, New Mexico

Provider Information

NPI Number: 1114696747
Entity Type: Individual
Name: Madison Lee Luttrell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Sep 8, 2021
Last Updated: Sep 8, 2021

Practice Location

Address: 1500 S AVE K
Address 2: STATION 3, SHROC
City: Portales
State: New Mexico
ZIP Code: 88130
Phone: (575) 562-4636

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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