MEDICARE: CHRISTELLA AMOUR LUTZ DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
2	374U00000X	Home Health Aide
3	385HR2065X	Child Physical Disabilities Respite Care
4	376K00000X	Nurse's Aide	600055130322	OH

General Provider Information

NPI Number	:	1083415491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTELLA AMOUR LUTZ DO

Provider Business Mailing Address
First Line	:	7316 PEBBLE CRK
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9484
Country	:	US
Telephone Number	:	513-668-6219
Fax Number	:

Provider Business Practice Location Address
First Line	:	7316 PEBBLE CRK
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9484
Country	:	US
Telephone Number	:	513-668-6219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	03/21/2025

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