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General NPI Number Information
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NPI Number | 1639680184
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Entity Type | Individual
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Provider Name | TERESA D LUTTRELL
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Gender | Female
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 501 LINCOLN AVE
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City | BEDFORD
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State | IN
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Zip | 47421-2140
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Country | US
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Telephone | 812-219-4834
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Fax |
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Provider Business Mailing Address
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Address Line | 1090 STATE ROAD 458
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City | BEDFORD
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State | IN
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Zip | 47421-7548
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Country | US
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Telephone | 812-275-6413
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 17001493A
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License Number State | IN
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