Provider Demographics
NPI:1538600499
Name:LUND, ANGELA (DC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:LUND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:AHRENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:222511 STARFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4599
Mailing Address - Country:US
Mailing Address - Phone:715-581-0528
Mailing Address - Fax:
Practice Address - Street 1:1105 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:ROTHSCHILD
Practice Address - State:WI
Practice Address - Zip Code:54474-1024
Practice Address - Country:US
Practice Address - Phone:715-842-2834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-13
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5259-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor