Provider Demographics
NPI:1487689485
Name:BENEDICT, LANCE C (DC)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:C
Last Name:BENEDICT
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 1:28 WHITE BRIDGE RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1499
Mailing Address - Country:US
Mailing Address - Phone:615-352-3000
Mailing Address - Fax:615-352-6673
Practice Address - Street 1:28 WHITE BRIDGE RD
Practice Address - Street 2:SUITE 208
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-1499
Practice Address - Country:US
Practice Address - Phone:615-352-3000
Practice Address - Fax:615-352-6673
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00757111N00000X
TNDC000000757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3675789Medicaid
TN3675789Medicaid
TN3675789Medicare PIN