Provider Demographics
NPI:1043347180
Name:BENTLEY SERVICES INC.
Entity Type:Organization
Organization Name:BENTLEY SERVICES INC.
Other - Org Name:BENTLEY CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-695-5525
Mailing Address - Street 1:67925 BANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-9301
Mailing Address - Country:US
Mailing Address - Phone:740-695-5525
Mailing Address - Fax:740-695-6209
Practice Address - Street 1:67925 BANFIELD RD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9301
Practice Address - Country:US
Practice Address - Phone:740-695-5525
Practice Address - Fax:740-695-6209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH581111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH581OtherHEALTH PLAN
OH000000152530OtherANTHEM
OH=========00OtherBWC
OH0399181Medicare ID - Type UnspecifiedMEDICARE
OH000000152530OtherANTHEM