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General NPI Number Information
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NPI Number | 1720058399
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Entity Type | Individual
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Provider Name | JENNIFER LUTZ PT
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2301 E EVESHAM RD SUITE 115, BLDG 800
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City | VOORHEES
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State | NJ
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Zip | 08043-4501
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Country | US
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Telephone | 856-770-9615
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 E EVESHAM RD SUITE 115, BLDG 800
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City | VOORHEES
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State | NJ
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Zip | 08043-4501
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Country | US
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Telephone | 856-770-9000
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 20801
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00932600
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License Number State | NJ
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