Healthcare Provider Details

I. General information

NPI: 1386441848
Provider Name (Legal Business Name): DAWN LUTTEKE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20683 560TH AVE
WELLS MN
56097-6285
US

IV. Provider business mailing address

20683 560TH AVE
WELLS MN
56097-6285
US

V. Phone/Fax

Practice location:
  • Phone: 507-391-4332
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number102326
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: