=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487530424
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WRESTLING WITH MEDICINE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2025
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 905 OAK RD
-----------------------------------------------------
City | HARLAN
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51537-5512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-783-4248
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 905 OAK RD
-----------------------------------------------------
City | HARLAN
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51537-5512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-783-4248
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ROBERT BENDORF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 515-783-4248
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------