Provider Demographics
NPI:1811054547
Name:LINDER, JORDAN BROOKS (DC)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:BROOKS
Last Name:LINDER
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 2144
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-2144
Mailing Address - Country:US
Mailing Address - Phone:563-271-5421
Mailing Address - Fax:
Practice Address - Street 1:102 CHURCH ST
Practice Address - Street 2:
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-3565
Practice Address - Country:US
Practice Address - Phone:563-271-5421
Practice Address - Fax:563-271-5421
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4275111N00000X
MT1180111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor