Provider Demographics
NPI:1144875659
Name:BINGHAM, BRADLEY (DC)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:BINGHAM
Suffix:
Gender:M
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:W189S7819 RACINE AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-9546
Mailing Address - Country:US
Mailing Address - Phone:262-679-2060
Mailing Address - Fax:262-421-2273
Practice Address - Street 1:W189S7819 RACINE AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGO
Practice Address - State:WI
Practice Address - Zip Code:53150-9546
Practice Address - Country:US
Practice Address - Phone:262-679-2060
Practice Address - Fax:262-421-2273
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5439111N00000X
IL038.013399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor