Provider Demographics
NPI:1346932993
Name:LUTHER, ELI (ABOC)
Entity Type:Individual
Prefix:
First Name:ELI
Middle Name:
Last Name:LUTHER
Suffix:
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-8337
Mailing Address - Country:US
Mailing Address - Phone:715-486-9365
Mailing Address - Fax:
Practice Address - Street 1:2001 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-8337
Practice Address - Country:US
Practice Address - Phone:715-486-9365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician