Individual
BENJAMIN J LUITJENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2105 E ENTERPRISE AVE, APPLETON, WI 54913-7862
(920) 560-1000
(920) 731-7133
Mailing address
2105 E ENTERPRISE AVE STE 112, APPLETON, WI 54913-7862
(920) 731-3111
(920) 731-7133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4803-23
WI
Other
Enumeration date
07/23/2019
Last updated
03/14/2023
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