Provider Demographics
NPI:1144406224
Name:BENAKOVICH, LAUREN HUNTER (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:HUNTER
Last Name:BENAKOVICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:HUNTER
Other - Last Name:MONTIETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:10725 WEST STATE ROAD 47
Mailing Address - Street 2:
Mailing Address - City:THORNTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46071
Mailing Address - Country:US
Mailing Address - Phone:317-617-3542
Mailing Address - Fax:317-245-8100
Practice Address - Street 1:10725 WEST STATE ROAD 47
Practice Address - Street 2:
Practice Address - City:THORNTOWN
Practice Address - State:IN
Practice Address - Zip Code:46071
Practice Address - Country:US
Practice Address - Phone:317-617-3542
Practice Address - Fax:317-245-8100
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002369A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor