Provider Demographics
NPI:1457801862
Name:BENZ, ROSS (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:
Last Name:BENZ
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 1:1759 E QUEEN CREEK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-2010
Mailing Address - Country:US
Mailing Address - Phone:386-527-9837
Mailing Address - Fax:
Practice Address - Street 1:1759 E QUEEN CREEK RD STE 2
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-2010
Practice Address - Country:US
Practice Address - Phone:386-527-9837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor