Lutz, John Roman
Lutz, John Roman is an sole proprietor health care provider with primary practice located at 240 Creekstone Rdg , Woodstock GA 30188-3732. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lutz, John Roman can be contacted via phone (770) 592-9065.Contact Information
Primary practice address
240 Creekstone Rdg
Woodstock GA 30188-3732
Phone: (770) 592-9065
Fax: (770) 592-9095
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY001726 | Georgia |
Profile Details
| NPI number | 1538235312 |
|---|---|
| LBN Legal business name | Lutz, John Roman |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 25th, 2006 |
| Last updated | Aug 15th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538235312 | NPPES |
| Georgia | MEDICAID | 000515171C |
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