Provider Demographics
NPI:1659329795
Name:LINDEN, BYRON LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:LEE
Last Name:LINDEN
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:PO BOX 626
Mailing Address - Street 2:246 MAIN ST.
Mailing Address - City:MOVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51039-0626
Mailing Address - Country:US
Mailing Address - Phone:712-873-5111
Mailing Address - Fax:712-873-5112
Practice Address - Street 1:246 MAIN ST.
Practice Address - Street 2:
Practice Address - City:MOVILLE
Practice Address - State:IA
Practice Address - Zip Code:51039-0626
Practice Address - Country:US
Practice Address - Phone:712-873-5111
Practice Address - Fax:712-873-5112
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4818111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
19051Medicare ID - Type Unspecified
IAT01100Medicare UPIN