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Individual
DR. BRADLEY BENTON LUTZ
Active
Individual
DR. BRADLEY BENTON LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TL9317
WY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/30/2023
Last updated
08/17/2026
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