Individual
BRIAN J LUTEYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027-2684
(262) 670-4000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7793
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100281663
—
WI
Enumeration date
12/06/2023
Last updated
08/02/2024
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