Individual
KENNETH DAVID LUNDEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
683
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z2293
HEALTH NET
AZ
01
—
650010309
RAILROAD MEDICARE
AZ
01
—
719065
AHCCCS
AZ
01
—
74518
BLUE CROSS BLUE SHIELD
AZ
01
—
860744695
UNITED HEALTHCARE
AZ
Enumeration date
02/28/2006
Last updated
06/08/2020
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