Provider Demographics
NPI:1679128664
Name:KLUNDT, LYNDSI E (PT)
Entity Type:Individual
Prefix:
First Name:LYNDSI
Middle Name:E
Last Name:KLUNDT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12938
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58208-2938
Mailing Address - Country:US
Mailing Address - Phone:701-746-8374
Mailing Address - Fax:701-780-0885
Practice Address - Street 1:403 BRIGGS AVE S
Practice Address - Street 2:
Practice Address - City:PARK RIVER
Practice Address - State:ND
Practice Address - Zip Code:58270-4023
Practice Address - Country:US
Practice Address - Phone:701-284-6707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist