Doctor Name: | DR. CHAD A LUNDSTROM |
NPI Number: | 1275621922 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 313921-1202 |
Business Practice Address: | 1790 Sun Peak Dr Ste. A-201 Park City, UT - 840986559 |
Business Phone Number: | 4356494424 |
Business Fax Number: | 4356493278 |
Mailing Address: | 6244 View Dr, PARK CITY |
State: | UT |
Postal Code: | 840986156 |
Phone Number: | 4356156684 |
Fax Number: | |
NPI Enumeration Date: | 10/10/2006 |
NPI Last Update Date: | 01/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 313921-1202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |