Individual
DEREK LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
834 THURBER DR W APT 25, COLUMBUS, OH 43215-1278
(740) 415-6316
Mailing address
351 MILL RD SW, LANCASTER, OH 43130-9039
(740) 415-6316
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT03402
SC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/12/2020
Last updated
10/05/2023
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