Individual
ZACHARY LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(215) 952-9010
Mailing address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA002858
PA
363AM0700X
Medical Physician Assistant
Primary
MA055497
PA
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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