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General NPI Number Information
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NPI Number | 1023292679
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Entity Type | Individual
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Provider Name | CARRIE BROOKE LUTZKE D.P.T.
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Gender | Female
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 02/03/2008
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Provider Practice Location Address
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Address Line | 187 E MARKET ST SUITE 142
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City | RHINEBECK
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State | NY
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Zip | 12572-1727
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Country | US
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Telephone | 845-876-3595
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Fax |
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Provider Business Mailing Address
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Address Line | 187 E MARKET ST SUITE 142
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City | RHINEBECK
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State | NY
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Zip | 12572-1727
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Country | US
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Telephone | 845-876-3595
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 029926
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License Number State | NY
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