Provider Demographics
NPI:1497799829
Name:BENNETT, CARY VM (DC)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:VM
Last Name:BENNETT
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 1:1015 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-3327
Mailing Address - Country:US
Mailing Address - Phone:256-734-5522
Mailing Address - Fax:256-737-9649
Practice Address - Street 1:1015 4TH ST SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3327
Practice Address - Country:US
Practice Address - Phone:256-734-5522
Practice Address - Fax:256-737-9649
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051557654Medicare PIN
000074918Medicare ID - Type Unspecified
T95956Medicare UPIN