Organization
LUNDELL CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN LUNDELL D.C (OWNER, CHIROPRACTOR)
(801) 810-2005
Entity
Organization
Contact information
Practice address
5348 S 1900 W, SUITE #A2, ROY, UT 84067-3019
(801) 810-2005
(801) 623-6777
Mailing address
5348 S 1900 W, SUITE #A2, ROY, UT 84067-3019
(801) 810-2005
(801) 623-6777
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7551637-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000069097
MEDICARE PTAN
UT
Enumeration date
06/17/2015
Last updated
08/05/2015
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