Ethan Dale Luttrell

NPI #1487212510 in Eldon, Missouri

Provider Information

NPI Number: 1487212510
Entity Type: Individual
Name: Ethan Dale Luttrell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Jun 4, 2019
Last Updated: Jun 4, 2019

Practice Location

Address: 302 E 4TH ST
City: Eldon
State: Missouri
ZIP Code: 65026-1808
Phone: (573) 392-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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