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General NPI Number Information
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NPI Number | 1245276302
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Entity Type | Individual
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Provider Name | DAVID ROBERT LUTZ D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 3326 SW 4TH PLACE
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City | CAPE CORAL
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State | FL
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Zip | 33914
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Country | US
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Telephone | 502-386-9385
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Fax |
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Provider Business Mailing Address
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Address Line | 3026 SW 4TH PL
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City | CAPE CORAL
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State | FL
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Zip | 33914-4595
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Country | US
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Telephone | 502-386-9385
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH12511
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4667
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License Number State | KY
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