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General NPI Number Information
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NPI Number | 1144158452
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Entity Type | Individual
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Provider Name | MR. BRAYDEN LUKE LUND
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Gender | Male
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 101 WEST AVE STE 101
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City | JENKINTOWN
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State | PA
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Zip | 19046-2041
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Country | US
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Telephone | 215-886-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 655 S WILLOW ST STE 128
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City | MANCHESTER
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State | NH
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Zip | 03103-5723
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Country | US
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Telephone | 800-995-2673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT034174
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License Number State | PA
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