Provider Demographics
NPI:1376306076
Name:LALUM, ANDREW STEPHEN
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:STEPHEN
Last Name:LALUM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 CASINO CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-7703
Mailing Address - Country:US
Mailing Address - Phone:406-366-9573
Mailing Address - Fax:
Practice Address - Street 1:1193 CASINO CREEK RD
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-7703
Practice Address - Country:US
Practice Address - Phone:406-366-9573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer