Individual
DEKE LUNDMAN
Active
Individual
DEKE LUNDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1511PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000600008
BCBS PIN
MT
05
—
0345610
—
MT
05
—
115476100
—
WY
Enumeration date
10/23/2006
Last updated
09/23/2009
Update your record
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