Provider Demographics
NPI:1497834733
Name:BENNINGFIELD, JESSICA MEYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MEYLOR
Last Name:BENNINGFIELD
Suffix:
Gender:F
Credentials:DC
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Mailing Address - Street 1:2785 CHARLOTTE HWY # HWY21
Mailing Address - Street 2:SUITE 23
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8050
Mailing Address - Country:US
Mailing Address - Phone:704-799-8060
Mailing Address - Fax:704-799-8131
Practice Address - Street 1:2785 CHARLOTTE HWY # HWY21
Practice Address - Street 2:SUITE 23
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8050
Practice Address - Country:US
Practice Address - Phone:704-799-8060
Practice Address - Fax:704-799-8131
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC3645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor