Provider Demographics
NPI:1508163254
Name:LINDBERG, NOBLE L III (NOBLE LINDBERG)
Entity Type:Individual
Prefix:DR
First Name:NOBLE
Middle Name:L
Last Name:LINDBERG
Suffix:III
Gender:M
Credentials:NOBLE LINDBERG
Other - Prefix:DR
Other - First Name:NOBLE
Other - Middle Name:L
Other - Last Name:LINDBERG
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:NOBLE LINDBERG DC
Mailing Address - Street 1:2404 S ORCHARD ST
Mailing Address - Street 2:STE 800
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-6719
Mailing Address - Country:US
Mailing Address - Phone:208-345-2222
Mailing Address - Fax:208-620-2215
Practice Address - Street 1:2404 S ORCHARD ST
Practice Address - Street 2:STE 800
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-6719
Practice Address - Country:US
Practice Address - Phone:208-345-2222
Practice Address - Fax:208-620-2215
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5491950-1202111N00000X
IDCHIA-1545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU000073667OtherPTAN