Provider Demographics
NPI:1437770518
Name:LUTZ GET HEALTHY LLC
Entity Type:Organization
Organization Name:LUTZ GET HEALTHY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:480-980-9582
Mailing Address - Street 1:2550 S ELLSWORTH RD UNIT 297
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-2207
Mailing Address - Country:US
Mailing Address - Phone:480-980-9582
Mailing Address - Fax:
Practice Address - Street 1:2550 S ELLSWORTH RD UNIT 297
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-2207
Practice Address - Country:US
Practice Address - Phone:480-980-9582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty