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NPI Code Detail

MEDICARE: MS. DONNA CAROL LUTHY L.AC.

MEDICARE: MS. DONNA CAROL LUTHY L.AC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist004153NY

General Provider Information

NPI Number : 1144508953
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DONNA CAROL LUTHY L.AC.
Provider Business Mailing Address
First Line : 167 OVID ST
Second Line :
City : SENECA FALLS
State : NY
Zip : 13148-2313
Country : US
Telephone Number : 315-545-2013
Fax Number :
Provider Business Practice Location Address
First Line : 611 N FRANKLIN ST
Second Line : SUITE 106
City : WATKINS GLEN
State : NY
Zip : 14891-1302
Country : US
Telephone Number : 315-545-2013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2011
Last Update Date : 07/27/2011

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