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1023862752
JACOB LUTGEN
WACO, TX
NPI
1023862752
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: TX BP10087790)
Enumeration Date
2024-04-17
Last Update Date
2024-04-17
Business Address
JACOB LUTGEN
1600 PROVIDENCE DR
WACO, TX 76707-2261
Phone number: 254-313-4200
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Mailing Address
JACOB LUTGEN
1600 PROVIDENCE DR
WACO, TX 76707-2261
Phone number: 254-313-4200
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