Individual
TRAVIS G. LUNDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
1400 E BOULDER ST STE 2508, COLORADO SPRINGS, CO 80909-5533
(719) 365-6999
(719) 365-2837
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4034
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
2014026440
MO
367H00000X
Anesthesiologist Assistant
Primary
ANT.0000138
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
07/30/2014
Last updated
11/17/2020
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