Individual
DR. ERIC LEE LUTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1041B OAKDALE RD, MODESTO, CA 95355-4512
(209) 521-9036
(209) 521-3531
Mailing address
1041B OAKDALE RD, MODESTO, CA 95355-4512
(209) 521-9036
(209) 521-3531
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC24486
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0244860
BLUESHIELD PROVIDER NUMBE
CA
01
—
DC24486
GENERAL INSURANCE NUMBER
CA
Enumeration date
07/25/2006
Last updated
07/08/2007
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