Healthcare Provider Details

I. General information

NPI: 1831329176
Provider Name (Legal Business Name): DANIELLE LUTZ MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE ADAMS MSPT

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 TUNNEL RD STE 202
POTTSVILLE PA
17901-3885
US

IV. Provider business mailing address

PO BOX 932184
ATLANTA GA
31193-2184
US

V. Phone/Fax

Practice location:
  • Phone: 570-622-0182
  • Fax: 570-622-0182
Mailing address:
  • Phone: 856-678-3484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT020017
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: