Provider Demographics
NPI:1588089965
Name:LINDBLOM, JOSHUA M
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:M
Last Name:LINDBLOM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 SWAN DR
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-5037
Mailing Address - Country:US
Mailing Address - Phone:918-336-8500
Mailing Address - Fax:918-333-0734
Practice Address - Street 1:1223 SWAN DR
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-5037
Practice Address - Country:US
Practice Address - Phone:918-336-8500
Practice Address - Fax:918-333-0734
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4240225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist