Provider Demographics
NPI:1205327673
Name:LUNN, CHRISTIAN BLAKE (ATC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:BLAKE
Last Name:LUNN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CHURCH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2411
Mailing Address - Country:US
Mailing Address - Phone:207-762-1328
Mailing Address - Fax:
Practice Address - Street 1:12 CHURCH ST APT 205
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2411
Practice Address - Country:US
Practice Address - Phone:207-762-1328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer