Provider Demographics
NPI:1891704367
Name:BENDER, CORINNE SOLLA (DC)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:SOLLA
Last Name:BENDER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E BELL RD
Mailing Address - Street 2:SUITE A-10
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2895
Mailing Address - Country:US
Mailing Address - Phone:602-404-2909
Mailing Address - Fax:
Practice Address - Street 1:1601 E BELL RD
Practice Address - Street 2:SUITE A-10
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-2895
Practice Address - Country:US
Practice Address - Phone:602-404-2909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ441535Medicaid
AZU37116Medicare UPIN
AZ441535Medicaid