Healthcare Provider Details

I. General information

NPI: 1568306850
Provider Name (Legal Business Name): AUSTEN ROALD LUND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2107 LAZELLE ST
STURGIS SD
57785
US

IV. Provider business mailing address

328 AURORA AVE
SPEARFISH SD
57783-6365
US

V. Phone/Fax

Practice location:
  • Phone: 605-561-1050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number6022
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: