Individual
DERRICK LUNDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1224 2ND ST NE, MINNEAPOLIS, MN 55413-1130
(612) 345-5648
Mailing address
2194 LEXINGTON AVE N APT 12, ROSEVILLE, MN 55113-4351
(651) 214-2476
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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