Individual
DR. RANDALL LUNDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
662 S FERGUSON AVE STE 1, BOZEMAN, MT 59718
(406) 586-1984
(406) 551-2049
Mailing address
662 S FERGUSON AVE STE 1, BOZEMAN, MT 59718-6492
(406) 586-1984
(406) 551-2049
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
708
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M011000443
MEDICARE PTAN
MT
Enumeration date
10/17/2006
Last updated
08/29/2018
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