Provider Demographics
NPI:1851428312
Name:FOX, DAVID BENTON (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BENTON
Last Name:FOX
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 1:429 PARK AVE WEST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906
Mailing Address - Country:US
Mailing Address - Phone:419-524-2255
Mailing Address - Fax:419-524-1645
Practice Address - Street 1:429 PARK AVE WEST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-524-2255
Practice Address - Fax:419-524-1645
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH851111N00000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No133N00000XDietary & Nutritional Service ProvidersNutritionist