Healthcare Provider Details

I. General information

NPI: 1326958109
Provider Name (Legal Business Name): FLOW STATE SPINE AND MOVEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 S UNIVERSITY AVE STE 400
BEAVER DAM WI
53916-3080
US

IV. Provider business mailing address

W8643 SHADY OAK LN
BEAVER DAM WI
53916-9766
US

V. Phone/Fax

Practice location:
  • Phone: 920-821-0071
  • Fax:
Mailing address:
  • Phone: 920-219-1123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. BENJAMIN DAVID SHIER
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 920-219-1123