Provider Demographics
NPI:1154620003
Name:LUTTRELL, JAMIE L (CST)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:LUTTRELL
Suffix:
Gender:F
Credentials:CST
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Other - Credentials:
Mailing Address - Street 1:27401 W HIGHWAY 22
Mailing Address - Street 2:SUITE 125
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5999
Mailing Address - Country:US
Mailing Address - Phone:847-381-0388
Mailing Address - Fax:847-381-0811
Practice Address - Street 1:27401 W HIGHWAY 22
Practice Address - Street 2:SUITE 125
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5999
Practice Address - Country:US
Practice Address - Phone:847-381-0388
Practice Address - Fax:847-381-0811
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist