Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Dale Luttrell

Individual provider Physical Therapy Assistant · NPI 1487212510

Ethan Dale Luttrell is a Physical Therapy Assistant in Eldon, Missouri. Licensed in Missouri. Registered with an NPI since 2019.

Licensed in
MO
In the registry since
2019

Practice location Address checks out

302 E 4th St
Eldon, MO 65026-1808
Phone: (573) 392-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2019018423 (MO)

Record details

NPI number1487212510
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 4, 2019
Last updated in NPPESJune 4, 2019
Mailing address302 E 4th St, Eldon, MO 65026-1808