Provider Demographics
NPI:1972305605
Name:LUNDBLAD, DAWN ALLISON (PT)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:ALLISON
Last Name:LUNDBLAD
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 1:992 SHEPARD HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-1338
Mailing Address - Country:US
Mailing Address - Phone:216-816-0098
Mailing Address - Fax:
Practice Address - Street 1:5844 DARROW RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-3864
Practice Address - Country:US
Practice Address - Phone:330-650-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT8366225100000X
GACP043257T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist