Provider Demographics
NPI:1790116499
Name:LINDELL, ALEX G (BA)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:G
Last Name:LINDELL
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-2506
Mailing Address - Country:US
Mailing Address - Phone:701-352-4346
Mailing Address - Fax:701-352-4590
Practice Address - Street 1:901 W MIDWAY DR
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-2506
Practice Address - Country:US
Practice Address - Phone:701-352-4346
Practice Address - Fax:701-352-4590
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator