Lundberg, Nathan Todd

Lundberg, Nathan Todd is an individual health care provider with primary practice located at 535 N Locust Grove Rd Ste 170 , Meridian ID 83642-9379. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Lundberg, Nathan Todd can be contacted via phone (208) 917-2660.

Contact Information

Primary practice address
535 N Locust Grove Rd Ste 170 Meridian ID 83642-9379
Phone: (208) 917-2660
Fax: (208) 917-2630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT7243 Idaho

Profile Details

NPI number 1316512015
LBN Legal business name Lundberg, Nathan Todd
Credentials PT, DPT
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2021
Last updated May 25th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316512015 NPPES
Idaho Other 7243 STATE LICENSE

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