Individual
DR. BLAKE JON LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1397 SILVER BLUFF RD STE 100, AIKEN, SC 29803-9784
(803) 220-1073
(803) 380-7044
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(866) 370-8206
(517) 435-3670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5520
ME
225100000X
Physical Therapist
Primary
CP022892T
NC
Other
Enumeration date
11/19/2019
Last updated
07/23/2025
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