Provider Demographics
NPI:1750468286
Name:LINEBARGER, CLETE THOMAS (DC)
Entity Type:Individual
Prefix:
First Name:CLETE
Middle Name:THOMAS
Last Name:LINEBARGER
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 1:2411 W MAIN STREET
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718
Mailing Address - Country:US
Mailing Address - Phone:406-586-1531
Mailing Address - Fax:406-587-5830
Practice Address - Street 1:2411 W MAIN STREET
Practice Address - Street 2:SUITE 1B
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718
Practice Address - Country:US
Practice Address - Phone:406-586-1531
Practice Address - Fax:406-587-5830
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41193OtherBLUE CROSS BLUE SHIELD