Provider Demographics
NPI:1841666831
Name:LUTES, MARGO (DPT)
Entity type:Individual
Prefix:
First Name:MARGO
Middle Name:
Last Name:LUTES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985450 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-5450
Mailing Address - Country:US
Mailing Address - Phone:402-559-6580
Mailing Address - Fax:402-559-5737
Practice Address - Street 1:444 S 44TH STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-4984
Practice Address - Country:US
Practice Address - Phone:402-559-5415
Practice Address - Fax:402-559-9263
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29722251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics