Individual
JULIAN RICHARD LUETMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 6TH AVE N, CENTRA CARE CLINIC, SAINT CLOUD, MN 56303-2735
(320) 252-3322
Mailing address
1200 6TH AVE N, CENTRA CARE CLINIC, SAINT CLOUD, MN 56303-2735
(320) 252-3322
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
11189
MN
363AS0400X
Surgical Physician Assistant
1762
MN
Other
Enumeration date
07/24/2012
Last updated
10/14/2013
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