Provider Demographics
NPI:1144508953
Name:LUTHY, DONNA CAROL (LAC)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:CAROL
Last Name:LUTHY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 OVID ST
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-2313
Mailing Address - Country:US
Mailing Address - Phone:315-545-2013
Mailing Address - Fax:
Practice Address - Street 1:611 N FRANKLIN ST
Practice Address - Street 2:SUITE 106
Practice Address - City:WATKINS GLEN
Practice Address - State:NY
Practice Address - Zip Code:14891-1302
Practice Address - Country:US
Practice Address - Phone:315-545-2013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004153171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist