Provider Demographics
NPI:1851880314
Name:BENNETT, BRITTNEY LAINE (DC)
Entity Type:Individual
Prefix:MISS
First Name:BRITTNEY
Middle Name:LAINE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4203 E US HIGHWAY 54
Mailing Address - Street 2:
Mailing Address - City:LINN CREEK
Mailing Address - State:MO
Mailing Address - Zip Code:65052-1745
Mailing Address - Country:US
Mailing Address - Phone:573-346-3777
Mailing Address - Fax:844-336-3777
Practice Address - Street 1:4203 E US HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:LINN CREEK
Practice Address - State:MO
Practice Address - Zip Code:65052-1745
Practice Address - Country:US
Practice Address - Phone:573-346-3777
Practice Address - Fax:844-336-3777
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016036641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty