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NPI Code Detail

MEDICARE: LUKE GUTTORMSON PT

MEDICARE: LUKE GUTTORMSON PT
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 Therapist17594-24CO

General Provider Information

NPI Number : 1831056969
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKE GUTTORMSON PT
Provider Business Mailing Address
First Line : 1650 LYNDON FARM CT STE 300
Second Line :
City : LOUISVILLE
State : KY
Zip : 40223-5005
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1266 W MAIN ST
Second Line :
City : SUN PRAIRIE
State : WI
Zip : 53590-1918
Country : US
Telephone Number : 608-318-1357
Fax Number : 608-318-5425
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2026
Last Update Date : 02/11/2026

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