Provider Demographics
NPI:1659543551
Name:LUNDELL ENTERPRISES INC.
Entity Type:Organization
Organization Name:LUNDELL ENTERPRISES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUNDELL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCKITTRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-949-0076
Mailing Address - Street 1:1114 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-9426
Mailing Address - Country:US
Mailing Address - Phone:318-949-0076
Mailing Address - Fax:318-949-0787
Practice Address - Street 1:1114 HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-9426
Practice Address - Country:US
Practice Address - Phone:318-949-0076
Practice Address - Fax:318-949-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA979111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty