Provider Demographics
NPI:1083385884
Name:BUNDY CHIROPRACTIC & WELLNESS
Entity Type:Organization
Organization Name:BUNDY CHIROPRACTIC & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:217-653-3083
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:LA HARPE
Mailing Address - State:IL
Mailing Address - Zip Code:61450-0157
Mailing Address - Country:US
Mailing Address - Phone:217-659-7806
Mailing Address - Fax:
Practice Address - Street 1:103 W 1ST AVE
Practice Address - Street 2:
Practice Address - City:LA HARPE
Practice Address - State:IL
Practice Address - Zip Code:61450-4940
Practice Address - Country:US
Practice Address - Phone:217-659-7806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty