Provider Demographics
NPI:1811301948
Name:BADINGER CHIROPRACTIC
Entity type:Organization
Organization Name:BADINGER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BADINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-239-4749
Mailing Address - Street 1:1617 32ND AVE S STE G
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5985
Mailing Address - Country:US
Mailing Address - Phone:701-239-4749
Mailing Address - Fax:701-356-5198
Practice Address - Street 1:1617 32ND AVE S STE G
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5985
Practice Address - Country:US
Practice Address - Phone:701-239-4749
Practice Address - Fax:701-356-5198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3K763BAOtherBCBS
ND17302Medicaid
ND11271OtherBCBS
NDU24441Medicare UPIN
ND17302Medicaid