Individual
BENJAMIN JOHN BREIDENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1640 GEORGE ST, LACROSSE, WI 54650
(608) 781-9880
(608) 783-5426
Mailing address
N5498 HWY 35, ONALASKA, WI 54650
(608) 779-5323
(608) 779-5328
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3676012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38927000
—
WI
Enumeration date
11/06/2006
Last updated
09/27/2011
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