Provider Demographics
NPI:1477820207
Name:LUND, ERIC LAWRENCE (MT-BC)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:LAWRENCE
Last Name:LUND
Suffix:
Gender:M
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 GREATWAY CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-3688
Mailing Address - Country:US
Mailing Address - Phone:651-307-0754
Mailing Address - Fax:
Practice Address - Street 1:621 S CULLEN AVE STE 118
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4137
Practice Address - Country:US
Practice Address - Phone:812-491-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist