Individual
REID LUNDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
35275 MARTIN ST, LAKE CITY, MN 55041-5601
(651) 448-0229
Mailing address
35275 MARTIN ST, LAKE CITY, MN 55041-5601
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13675
LICENSE
MN
Enumeration date
02/20/2019
Last updated
02/02/2024
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