Provider Demographics
NPI:1952377293
Name:BENSON, RACHEL JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:JEAN
Last Name:BENSON
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 1:824 UNIVERSITY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58203-3547
Mailing Address - Country:US
Mailing Address - Phone:218-230-1700
Mailing Address - Fax:
Practice Address - Street 1:824 UNIVERSITY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-3547
Practice Address - Country:US
Practice Address - Phone:218-230-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND14826Medicaid
NDN713609Medicare PIN
V05410Medicare UPIN