| NPI | 1962902403 |
|---|---|
| Doing Business As | DYNAMIC SPORTS REHAB |
| Entity Type | Organization |
| Authorized Contact | SHAWN CONRAD LUTZ Owner 458-206-6123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor Sports Physician (Licence: OR 4064) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2022-02-16 |