Individual
JON RICHARD LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20670 HOOVER BAULT RD, MARYSVILLE, OH 43040-9258
(937) 707-0433
Mailing address
20670 HOOVER BAULT RD, MARYSVILLE, OH 43040-9258
(937) 707-0433
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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