Individual
DR. CLARK D LUNDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2401 MAIN ST E, SUITE A, THOMPSON FALLS, MT 59873
(406) 827-5500
(406) 827-1986
Mailing address
PO BOX 2084, 2401 MAIN ST E SUITE A, THOMPSON FALLS, MT 59873
(406) 827-5500
(406) 827-1986
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
472
MT
111N00000X
Chiropractor
Primary
MT472
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0165360
—
MT
05
—
0165376
—
MT
01
—
1376639633
CHIROPRACTIC
MT
01
—
40933
BCBS
MT
Enumeration date
10/05/2006
Last updated
05/23/2018
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