Provider Demographics
NPI:1184273013
Name:BENNETT CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:BENNETT CHIROPRACTIC, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:ALASTAIR
Authorized Official - Last Name:A BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:845-493-0138
Mailing Address - Street 1:126 S QUAKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-3421
Mailing Address - Country:US
Mailing Address - Phone:845-709-9787
Mailing Address - Fax:
Practice Address - Street 1:198 ROUTE 22 STE 1B
Practice Address - Street 2:
Practice Address - City:PAWLING
Practice Address - State:NY
Practice Address - Zip Code:12564-3242
Practice Address - Country:US
Practice Address - Phone:845-493-0138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty