Provider Demographics
NPI:1053647560
Name:BENNETT, KAYLA DAWN (DC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:DAWN
Last Name:BENNETT
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 1:4185 E WILDCAT RESERVE PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-6804
Mailing Address - Country:US
Mailing Address - Phone:303-993-2134
Mailing Address - Fax:303-993-2008
Practice Address - Street 1:4185 E WILDCAT RESERVE PKWY STE 210
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-6804
Practice Address - Country:US
Practice Address - Phone:303-993-2134
Practice Address - Fax:303-993-2008
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.011504111N00000X
CO6491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor