Individual
DR. JOHNATHAN MARK LUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
964 AJAX STREET, JACKSONVILLE, FL 32212
(904) 546-7094
Mailing address
8901 WISCONSIN AVE, BETHESDA, MD 20889-0004
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0102208035
VA
Other
Enumeration date
04/14/2022
Last updated
03/12/2024
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