Provider Demographics
NPI:1568739936
Name:LUNDGREN, KRISTIN (ATC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LUNDGREN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 SHAFFER PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4111
Mailing Address - Country:US
Mailing Address - Phone:303-986-5200
Mailing Address - Fax:303-986-5222
Practice Address - Street 1:8101 SHAFFER PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4111
Practice Address - Country:US
Practice Address - Phone:303-986-5200
Practice Address - Fax:303-986-5222
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAT-8242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer