Doctor Name: | SETH LAUTERBACH |
NPI Number: | 1063733988 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1017 Grove Avenue Crete, NE - 68333 |
Business Phone Number: | 4023107913 |
Business Fax Number: | |
Mailing Address: | 1017 Grove Ave, CRETE |
State: | NE |
Postal Code: | 683332349 |
Phone Number: | 4023107913 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2010 |
NPI Last Update Date: | 10/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |