Organization
LUTHER LAKE EMERGENCY PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN KONDAS (OFFICER)
(973) 251-1132
Entity
Organization
Contact information
Practice address
111 HIGHWAY 70 E, DICKSON, TN 37055-2080
(973) 251-1132
Mailing address
18167 US HIGHWAY 19 N, SUITE 650, CLEARWATER, FL 33764-3528
(954) 838-2371
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
10/16/2013
Last updated
12/06/2019
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