Provider Demographics
NPI:1174713036
Name:LINNEBUR, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LINNEBUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12946 FOOTHILL RD
Mailing Address - Street 2:
Mailing Address - City:SPEARVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67876-8726
Mailing Address - Country:US
Mailing Address - Phone:620-385-2206
Mailing Address - Fax:
Practice Address - Street 1:700 CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:KS
Practice Address - Zip Code:66066-5054
Practice Address - Country:US
Practice Address - Phone:615-896-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01268225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant