Provider Demographics
NPI:1770621450
Name:BENDER, CHANDRA L (PHYSICAL TH ASST)
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:L
Last Name:BENDER
Suffix:
Gender:F
Credentials:PHYSICAL TH ASST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WALNUT ST
Mailing Address - Street 2:P.O. BOX 147
Mailing Address - City:BATTLE CREEK
Mailing Address - State:IA
Mailing Address - Zip Code:51006-5017
Mailing Address - Country:US
Mailing Address - Phone:712-732-7725
Mailing Address - Fax:712-732-5153
Practice Address - Street 1:301 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:IA
Practice Address - Zip Code:51006-5017
Practice Address - Country:US
Practice Address - Phone:712-732-7725
Practice Address - Fax:712-732-5153
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA912225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant