Provider Demographics
NPI:1154595510
Name:BOND FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:BOND FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:509-926-2511
Mailing Address - Street 1:100 N PINES RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5117
Mailing Address - Country:US
Mailing Address - Phone:509-926-2511
Mailing Address - Fax:509-926-3002
Practice Address - Street 1:100 N PINES RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5117
Practice Address - Country:US
Practice Address - Phone:509-926-2511
Practice Address - Fax:509-926-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU22092Medicare UPIN