MEDICARE: OLIVIA LUTHER RD, M.S

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
1	133V00000X	Registered Dietitian		TN

General Provider Information

NPI Number	:	1427886167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVIA LUTHER RD, M.S

Provider Business Mailing Address
First Line	:	10273 OAK BANK CV
Second Line	:
City	:	LAKELAND
State	:	TN
Zip	:	38002-8545
Country	:	US
Telephone Number	:	901-389-0798
Fax Number	:

Provider Business Practice Location Address
First Line	:	10273 OAK BANK CV
Second Line	:
City	:	LAKELAND
State	:	TN
Zip	:	38002-8545
Country	:	US
Telephone Number	:	901-389-0798
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2024
Last Update Date	:	07/24/2024

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