Provider Demographics
NPI:1477080109
Name:LINDNER, JACOB (DC)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:LINDNER
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 1:103 ELM ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WOODRUFF
Mailing Address - State:WI
Mailing Address - Zip Code:54568-9164
Mailing Address - Country:US
Mailing Address - Phone:715-358-6650
Mailing Address - Fax:715-358-6381
Practice Address - Street 1:103 ELM ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WOODRUFF
Practice Address - State:WI
Practice Address - Zip Code:54568-9164
Practice Address - Country:US
Practice Address - Phone:715-358-6650
Practice Address - Fax:715-358-6381
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5282-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor