Provider Demographics
NPI:1255005922
Name:LUNDAHL, HAYDEN CHRISTINE (DPT)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:CHRISTINE
Last Name:LUNDAHL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 NEW WAVERLY PL STE 120
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7405
Mailing Address - Country:US
Mailing Address - Phone:919-803-3398
Mailing Address - Fax:
Practice Address - Street 1:570 NEW WAVERLY PL STE 120
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7405
Practice Address - Country:US
Practice Address - Phone:919-803-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist