Individual
KIPTON J V LUNDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 PARK AVE, P5, MINNEAPOLIS, MN 55415-1623
(612) 873-2810
Mailing address
5933 TAMARAC AVE, EDINA, MN 55436-1745
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
24005
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
933567600
—
MN
Enumeration date
06/28/2006
Last updated
12/30/2011
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