Provider Demographics
NPI:1891702221
Name:BENNINGFIELD, ROBERT SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:BENNINGFIELD
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 1:123 SOUTHHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-7563
Mailing Address - Country:US
Mailing Address - Phone:704-799-8060
Mailing Address - Fax:704-799-8131
Practice Address - Street 1:2785 CHARLOTTE HWY STE 21
Practice Address - Street 2:SUITE 23
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9510
Practice Address - Country:US
Practice Address - Phone:704-799-8060
Practice Address - Fax:704-799-8131
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor