Provider Demographics
NPI:1336616309
Name:BENDER CHIROPRACTIC HEALTH AND VITALITY CENTER LLC
Entity Type:Organization
Organization Name:BENDER CHIROPRACTIC HEALTH AND VITALITY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:586-296-6242
Mailing Address - Street 1:33580 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4238
Mailing Address - Country:US
Mailing Address - Phone:586-296-6242
Mailing Address - Fax:
Practice Address - Street 1:33580 HARPER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-4238
Practice Address - Country:US
Practice Address - Phone:586-296-6242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty