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NPI Code Detail

MEDICARE: MRS. TARA DANIELLE LUETKENHAUS PT, DPT

MEDICARE: MRS. TARA DANIELLE LUETKENHAUS PT, DPT
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
1225100000XPhysical Therapist2660NE

General Provider Information

NPI Number : 1770744666
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TARA DANIELLE LUETKENHAUS PT, DPT
Provider Business Mailing Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3900
Fax Number : 402-413-3908
Provider Business Practice Location Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3900
Fax Number : 402-413-3908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2008
Last Update Date : 01/17/2026

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