Individual
AMBER LAUTZENHEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1100 MERCER AVE, DECATUR, IN 46733
(260) 724-2145
Mailing address
3660 N LAKE SHORE DR, APT 3304, CHICAGO, IL 60613-5300
(813) 382-4986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02005395A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2015
Last updated
07/12/2018
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