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Individual

JALEN K LUTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1930 BLANDING ST, COLUMBIA, SC 29201-3520
(180) 325-6410
Mailing address
4615 FOREST DR APT 521, COLUMBIA, SC 29206-3181
(256) 682-2503

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-179366
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
31439
SC

Other

Enumeration date
06/20/2023
Last updated
06/08/2026
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