Lundgren, Clark D
Lundgren, Clark D is an sole proprietor health care provider with primary practice located at 2401 Main St E Suite A, Thompson Falls MT 59873. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Lundgren, Clark D can be contacted via phone (406) 827-5500.Contact Information
Primary practice address
2401 Main St E Suite A
Thompson Falls MT 59873
Phone: (406) 827-5500
Fax: (406) 827-1986
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 472 | Montana |
| Chiropractic Providers / Chiropractor | 111N00000X | MT472 | Montana |
Profile Details
| NPI number | 1376639633 |
|---|---|
| LBN Legal business name | Lundgren, Clark D |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 5th, 2006 |
| Last updated | May 23rd, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376639633 | NPPES |
| Montana | MEDICAID | 0165360 | |
| Montana | Other | 40933 | |
| Montana | MEDICAID | 0165376 | |
| Montana | Other | 1376639633 |
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