Provider Demographics
NPI:1598041956
Name:WHITTEN, BENJAMIN SEAR (DC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:SEAR
Last Name:WHITTEN
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 1:510 22ND AVE E
Mailing Address - Street 2:SUITE 701
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4653
Mailing Address - Country:US
Mailing Address - Phone:320-763-9711
Mailing Address - Fax:320-762-1278
Practice Address - Street 1:510 22ND AVE E
Practice Address - Street 2:SUITE 701
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4653
Practice Address - Country:US
Practice Address - Phone:320-763-9711
Practice Address - Fax:320-762-1278
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5835OtherMN CHIROPRACTIC LICENSE
AK540OtherAK LICENSE NUMBER