Individual
JACLYN LUTZOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-7200
Mailing address
1836 EDMUND RD, ABINGTON, PA 19001-2012
(215) 421-4339
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP026727
PA
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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