Provider Demographics
NPI:1003985722
Name:BENNINGFIELD FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:BENNINGFIELD FAMILY CHIROPRACTIC PLLC
Other - Org Name:BENNINGFIELD CHIROPRACTIC PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BENNINGFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:704-799-8060
Mailing Address - Street 1:2785 CHARLOTTE HWY 21
Mailing Address - Street 2:SUITE 23
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9510
Mailing Address - Country:US
Mailing Address - Phone:704-799-8060
Mailing Address - Fax:704-799-8131
Practice Address - Street 1:2785 CHARLOTTE HWY 21
Practice Address - Street 2:SUITE 23
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9510
Practice Address - Country:US
Practice Address - Phone:704-799-8060
Practice Address - Fax:704-799-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2335826Medicare PIN