Organization
LON LUTZ,MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER LUTZ (OFFICE MANAGER)
(651) 313-8254
Entity
Organization
Contact information
Practice address
548 FOXWOOD LN, MENDOTA HTS, MN 55118-2808
(651) 313-8250
(651) 313-8251
Mailing address
548 FOXWOOD LN, MENDOTA HTS, MN 55118-2808
(651) 313-8250
(651) 313-8251
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
30820
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952352221
—
MN
Enumeration date
05/03/2011
Last updated
03/23/2017
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