Individual
PAULA LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
2202 LAPORTE AVE, VALPARAISO, IN 46383-5936
(219) 462-7577
(219) 462-7579
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010430A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000700991
ANTHEM
IN
05
—
201006510
—
IN
Enumeration date
01/05/2011
Last updated
04/23/2015
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