Provider Demographics
NPI:1083018089
Name:BINDER FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BINDER FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-349-2068
Mailing Address - Street 1:2901 35TH ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-5119
Mailing Address - Country:US
Mailing Address - Phone:920-980-0996
Mailing Address - Fax:
Practice Address - Street 1:2901 35TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-5119
Practice Address - Country:US
Practice Address - Phone:920-980-0996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4912-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1225374960OtherNPI
WI1043556780OtherNPI