Provider Demographics
NPI:1609995604
Name:LUTZ, JEFFREY A (LMT, CMTPT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:LUTZ
Suffix:
Gender:M
Credentials:LMT, CMTPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 HEMPFIELD PLAZA BLVD
Mailing Address - Street 2:SUITE 982
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1483
Mailing Address - Country:US
Mailing Address - Phone:724-853-2353
Mailing Address - Fax:724-853-2354
Practice Address - Street 1:4000 HEMPFIELD PLAZA BLVD
Practice Address - Street 2:SUITE 982
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1483
Practice Address - Country:US
Practice Address - Phone:724-853-2353
Practice Address - Fax:724-853-2354
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG002945225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist