Provider Demographics
NPI:1396864658
Name:BENSON, KARLYNN LEE (DC)
Entity Type:Individual
Prefix:
First Name:KARLYNN
Middle Name:LEE
Last Name:BENSON
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 1:12940 HARRIET AVE S
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2680
Mailing Address - Country:US
Mailing Address - Phone:952-707-8588
Mailing Address - Fax:952-707-8598
Practice Address - Street 1:12940 HARRIET AVE S
Practice Address - Street 2:SUITE 240
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2680
Practice Address - Country:US
Practice Address - Phone:952-707-8588
Practice Address - Fax:952-707-8598
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN537226700OtherMN-ITS PROVIDER NUMBER
MN537226700OtherMN-ITS PROVIDER NUMBER
MNU39486Medicare UPIN