Provider Demographics
NPI:1285871541
Name:KUN-HONG LU, PC
Entity type:Organization
Organization Name:KUN-HONG LU, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KUN-HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-236-8811
Mailing Address - Street 1:PO BOX 596
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-0596
Mailing Address - Country:US
Mailing Address - Phone:641-236-8811
Mailing Address - Fax:641-236-8818
Practice Address - Street 1:827 HIGH ST
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-2132
Practice Address - Country:US
Practice Address - Phone:641-236-8811
Practice Address - Fax:641-236-8818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06769104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty