Individual
JACOB LUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
4145 S NATIONAL AVE, SPRINGFIELD, MO 65807-5356
(417) 889-7500
Mailing address
4145 S NATIONAL AVE, SPRINGFIELD, MO 65807-5356
(319) 721-3999
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2021029342
MO
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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