Provider Demographics
NPI:1073580296
Name:LUND, ROBIN LEA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LEA
Last Name:LUND
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:LEA
Other - Last Name:SEMRAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1020 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-4707
Mailing Address - Country:US
Mailing Address - Phone:605-782-8494
Mailing Address - Fax:605-782-2401
Practice Address - Street 1:1020 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4707
Practice Address - Country:US
Practice Address - Phone:605-782-8494
Practice Address - Fax:605-782-2401
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9207903OtherDAKOTA CARE
SD5833530Medicaid
SD0040603OtherWELLMARK
SD0040603OtherWELLMARK