Provider Demographics
NPI:1922446046
Name:DUNHAM CHRISTENSON, LORI MAE (CMT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:MAE
Last Name:DUNHAM CHRISTENSON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 JESSICA CT
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-2611
Mailing Address - Country:US
Mailing Address - Phone:651-492-9350
Mailing Address - Fax:
Practice Address - Street 1:3440 FEDERAL DR
Practice Address - Street 2:SUITE 120
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3501
Practice Address - Country:US
Practice Address - Phone:651-492-9350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist