Provider Demographics
NPI:1881099711
Name:PREFERRED CARE PHYSIOTHERAPY CHIROPRACTIC & WEIGHTLOSS CENTER
Entity type:Organization
Organization Name:PREFERRED CARE PHYSIOTHERAPY CHIROPRACTIC & WEIGHTLOSS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-922-2898
Mailing Address - Street 1:10209 GIBSONTON DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-5310
Mailing Address - Country:US
Mailing Address - Phone:813-922-2898
Mailing Address - Fax:
Practice Address - Street 1:10209 GIBSONTON DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5310
Practice Address - Country:US
Practice Address - Phone:813-922-2898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty