Individual
ALEXANDRA LUTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 RIDGEWOOD DR, BOWLING GREEN, OH 43402-2696
(855) 289-1722
Mailing address
1234 RIDGEWOOD DR, BOWLING GREEN, OH 43402-2696
(855) 289-1722
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
12/30/2019
Last updated
12/30/2019
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