MEDICARE: SCOTT A. LUTZ PT

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	2251X0800X	Orthopedic Physical Therapist	A3380	NC

General Provider Information

NPI Number	:	1386821353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT A. LUTZ PT

Provider Business Mailing Address
First Line	:	902 NORTH HOWE STREET
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-3038
Country	:	US
Telephone Number	:	910-457-4789
Fax Number	:	910-457-5824

Provider Business Practice Location Address
First Line	:	902 NORTH HOWE STREET
Second Line	:
City	:	SOUTHPORT
State	:	NC
Zip	:	28461-3038
Country	:	US
Telephone Number	:	910-457-4789
Fax Number	:	910-457-5824

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

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	01/22/2008

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Directions to “ SCOTT A. LUTZ PT” Practice Location

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