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RIVERS LUTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
1220 N SHORE PKWY, SUITE B, BRANDON, MS 39047-6383
(601) 829-0505
(601) 829-0506
Mailing address
2416 HIGHWAY 45 N, COLUMBUS, MS 39705-1320
(662) 327-6705
(662) 327-6760

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5960
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
YAQ868756239M
BLUE CROSS BLUE SHIELD
MS
Enumeration date
05/11/2016
Last updated
11/07/2016
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