Individual
ELISIA MARIE LUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
402 N BABCOCK ST, SUITE 102, MELBOURNE, FL 32935-7335
(321) 241-6540
Mailing address
402 N BABCOCK ST, SUITE 102, MELBOURNE, FL 32935-7335
(321) 241-6540
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107031
FL
Other
Enumeration date
01/09/2013
Last updated
08/30/2016
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