Provider Demographics
NPI:1992855399
Name:BENNETT, AMY LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LYNN
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 1:107 BENEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-3176
Mailing Address - Country:US
Mailing Address - Phone:615-751-1001
Mailing Address - Fax:
Practice Address - Street 1:2805 OLD FORT PKWY
Practice Address - Street 2:SUITE D
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-5115
Practice Address - Country:US
Practice Address - Phone:615-893-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000002147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor