Provider Demographics
NPI:1922645852
Name:BENNE FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BENNE FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-791-3636
Mailing Address - Street 1:2335 W MAIN ST STE 330
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2435
Mailing Address - Country:US
Mailing Address - Phone:605-791-3636
Mailing Address - Fax:605-791-3637
Practice Address - Street 1:2335 W MAIN ST STE 330
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2435
Practice Address - Country:US
Practice Address - Phone:605-791-3636
Practice Address - Fax:605-791-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty