Provider Demographics
NPI:1518295187
Name:BADGER HORNFELD CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BADGER HORNFELD CHIROPRACTIC LLC
Other - Org Name:HORIZON SPINE AND SPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:BADGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-301-1449
Mailing Address - Street 1:2451 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5790
Mailing Address - Country:US
Mailing Address - Phone:702-233-2225
Mailing Address - Fax:702-233-3508
Practice Address - Street 1:280 W COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7776
Practice Address - Country:US
Practice Address - Phone:702-564-0904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01309111N00000X
NVB01312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty