Provider Demographics
NPI:1962707299
Name:LINDBERG, WILLAIM HAROLD
Entity type:Individual
Prefix:MR
First Name:WILLAIM
Middle Name:HAROLD
Last Name:LINDBERG
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:PO BOX 2585
Mailing Address - Street 2:
Mailing Address - City:MILLS
Mailing Address - State:WY
Mailing Address - Zip Code:82644-2585
Mailing Address - Country:US
Mailing Address - Phone:307-266-3070
Mailing Address - Fax:307-234-3171
Practice Address - Street 1:520 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2313
Practice Address - Country:US
Practice Address - Phone:307-266-3070
Practice Address - Fax:307-234-3171
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator