Organization
SHAWN LUTZ DC LLC
Active
Organization
SHAWN LUTZ DC LLC
Active
Other names
Dynamic Sports Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN CONRAD LUTZ DC (OWNER)
(458) 206-6123
Entity
Organization
Contact information
Practice address
296 SW COLUMBIA ST STE D1, BEND, OR 97702-1020
(541) 600-2558
(541) 833-0562
Mailing address
296 SW COLUMBIA ST STE D1, BEND, OR 97702-1020
(541) 600-2558
(541) 833-0562
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
4064
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093012999
NPI
—
Enumeration date
02/20/2018
Last updated
02/16/2022
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