Individual
LAUREL LUETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2750 S ROOSEVELT ST, WICHITA, KS 67210-1304
(316) 262-2415
Mailing address
2750 S ROOSEVELT ST, WICHITA, KS 67210-1304
(316) 262-2415
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-02520
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/10/2021
Last updated
01/20/2023
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