Provider Demographics
NPI:1912107509
Name:LUTRIN, SANDY (ND)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:
Last Name:LUTRIN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 E SHERRAN LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7024
Mailing Address - Country:US
Mailing Address - Phone:602-330-2278
Mailing Address - Fax:602-956-5699
Practice Address - Street 1:2912 E SHERRAN LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7024
Practice Address - Country:US
Practice Address - Phone:602-330-2278
Practice Address - Fax:602-956-5699
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03-771175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath