Provider Demographics
NPI:1942006531
Name:LUNT, EVERETT GREGG (DPT)
Entity type:Individual
Prefix:
First Name:EVERETT
Middle Name:GREGG
Last Name:LUNT
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 S DOBSON RD UNIT 34
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-3906
Mailing Address - Country:US
Mailing Address - Phone:480-465-0109
Mailing Address - Fax:
Practice Address - Street 1:8410 W THOMAS RD STE 136
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3374
Practice Address - Country:US
Practice Address - Phone:162-324-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-034061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist