Provider Demographics
NPI:1275525073
Name:LINDER, DARRYL T (DC)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:T
Last Name:LINDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4151 LAKE WORTH RD # 5995
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3926
Mailing Address - Country:US
Mailing Address - Phone:561-967-1950
Mailing Address - Fax:561-967-3735
Practice Address - Street 1:5891 S MILITARY TRL STE 3A
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6920
Practice Address - Country:US
Practice Address - Phone:561-967-1950
Practice Address - Fax:561-967-3735
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3721111N00000X
FLCH11207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor