Provider Demographics
NPI:1578887469
Name:LUTHMAN, MICHELLE EVELYN
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:EVELYN
Last Name:LUTHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 BUSCHOR RD
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-9703
Mailing Address - Country:US
Mailing Address - Phone:419-678-1021
Mailing Address - Fax:
Practice Address - Street 1:522 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SAINT HENRY
Practice Address - State:OH
Practice Address - Zip Code:45883-9777
Practice Address - Country:US
Practice Address - Phone:419-678-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-21
Last Update Date:2010-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT6139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist