Individual
MRS. KELLY KATHLEEN LUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1630 N ATHERTON ST, STATE COLLEGE, PA 16803-1416
(814) 238-1279
(814) 238-1929
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA056994
PA
363A00000X
Physician Assistant
OA003347
PA
363AM0700X
Medical Physician Assistant
MA056994
PA
Other
Enumeration date
10/09/2014
Last updated
08/26/2020
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