Individual
LOGAN LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4236 S 89TH ST, GREENFIELD, WI 53228-2212
(414) 702-8056
Mailing address
4236 S 89TH ST, GREENFIELD, WI 53228-2212
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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