Provider Demographics
NPI:1922318625
Name:BENNETT, CHRISTOPHER BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:BENNETT
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 1:3385 WALDON RD
Mailing Address - Street 2:
Mailing Address - City:ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-1648
Mailing Address - Country:US
Mailing Address - Phone:248-391-6101
Mailing Address - Fax:248-391-6102
Practice Address - Street 1:3385 WALDON RD
Practice Address - Street 2:
Practice Address - City:ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1648
Practice Address - Country:US
Practice Address - Phone:248-391-6101
Practice Address - Fax:248-391-6102
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor