Individual
NATHAN LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, AT, ATC
Contact information
Practice address
2770 KNAPP ST NE, GRAND RAPIDS, MI 49525-4422
(616) 648-7505
Mailing address
4254 TURTLE BEND DR SW APT 5, GRANDVILLE, MI 49418-2516
(616) 648-7505
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001100
MI
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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