Provider Demographics
NPI:1376664102
Name:LUTZ PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:LUTZ PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:972-395-7445
Mailing Address - Street 1:3733 N JOSEY LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2469
Mailing Address - Country:US
Mailing Address - Phone:972-395-7445
Mailing Address - Fax:972-395-7882
Practice Address - Street 1:3733 N JOSEY LN
Practice Address - Street 2:SUITE 100
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2469
Practice Address - Country:US
Practice Address - Phone:972-395-7445
Practice Address - Fax:972-395-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty