Basic Information
| Provider Information | |||||||||
| NPI: | 1598050106 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOUTHAN | ||||||||
| FirstName: | SHARON | ||||||||
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| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S. PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11133 O ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681372337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7654610922 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4710 SLIDE RD | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794143404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067973481 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2011 | ||||||||
| LastUpdateDate: | 06/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1164749 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.