Individual
RICHARD WAYNE LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
600 W 98TH ST, #390, BLOOMINGTON, MN 55420-4773
(952) 885-6200
Mailing address
1914 WORDSWORTH AVE, SAINT PAUL, MN 55116-2640
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5029
MN
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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