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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