Provider Demographics
NPI:1467627331
Name:BEMBENEK, ROBERT ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANTHONY
Last Name:BEMBENEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:602-222-9595
Mailing Address - Fax:602-234-1211
Practice Address - Street 1:5030 W MCDOWELL SUITE 10
Practice Address - Street 2:
Practice Address - City:PHX
Practice Address - State:AZ
Practice Address - Zip Code:85035
Practice Address - Country:US
Practice Address - Phone:602-278-8115
Practice Address - Fax:602-278-4029
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor