Provider Demographics
NPI:1477224970
Name:LUNDAK, PETER ANTHONY
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:ANTHONY
Last Name:LUNDAK
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 1:1038 NEWTON RD APT 10
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2296
Mailing Address - Country:US
Mailing Address - Phone:402-319-2705
Mailing Address - Fax:
Practice Address - Street 1:1038 NEWTON RD APT 10
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-2296
Practice Address - Country:US
Practice Address - Phone:402-319-2705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer