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NPI Code Detail

MEDICARE: THERESA A LUTTRELL STROUP OTR

MEDICARE: THERESA A LUTTRELL STROUP OTR
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
1225X00000XOccupational Therapist31000264AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200863570OTHERINFIRST STEPS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295929313
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA A LUTTRELL STROUP OTR
Provider Business Mailing Address
First Line : 750 W OAK ST
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-1205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9919 TOWNE RD
Second Line :
City : CARMEL
State : IN
Zip : 46032-8260
Country : US
Telephone Number : 317-872-4166
Fax Number : 317-872-3230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2007
Last Update Date : 08/31/2007

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Directions to “ THERESA A LUTTRELL STROUP OTR” Practice Location

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