Individual
TAUSHA LUTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8609 E 116TH ST, FISHERS, IN 46038-1560
(317) 709-4559
Mailing address
784 N PENDLETON AVE, PENDLETON, IN 46064-8977
(317) 709-4559
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT20903175
IN
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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