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NPI 1144875659

NPI 1144875659 : BRADLEY BINGHAM DC : MUSKEGO, WI

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General NPI Number Information
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    NPI Number           |    1144875659
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    Entity Type          |    Individual 
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    Provider Name        |    BRADLEY BINGHAM DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/02/2019
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    Last Update Date     |    08/29/2025
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Provider Practice Location Address
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    Address Line         |    W189S7819 RACINE AVE 
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    City                 |    MUSKEGO
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    State                |    WI
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    Zip                  |    53150-9546
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    Country              |    US
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    Telephone            |    262-679-2060
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    Fax                  |    262-421-2273
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Provider Business Mailing Address
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    Address Line         |    W189S7819 RACINE AVE 
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    City                 |    MUSKEGO
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    State                |    WI
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    Zip                  |    53150-9546
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    Country              |    US
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    Telephone            |    262-679-2060
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    Fax                  |    262-421-2273
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    5439
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    License Number State |    WI
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