Individual
KELLY LUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1628 ATTILBURGH BLVD, WEST MELBOURNE, FL 32904-6465
(219) 928-0625
Mailing address
1628 ATTILBURGH BLVD, WEST MELBOURNE, FL 32904
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16493
FL
Other
Enumeration date
10/04/2014
Last updated
03/31/2016
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