| Bennett Family Chiropractic, Llc | |
|
950 Yale Ave Suite 29 Wallingford CT 06492-1858 | |
| (203) 793-7147 | |
| (203) 793-7214 |
| Full Name | Bennett Family Chiropractic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 950 Yale Ave, Wallingford, Connecticut |
| Authorized Official Name and Position | Stephanie Marie Bennett (CHIROPRACTOR) |
| Authorized Official Contact | 2037937147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bennett Family Chiropractic, Llc 950 Yale Ave Suite 29 Wallingford CT 06492-1858 Ph: (203) 793-7147 | Bennett Family Chiropractic, Llc 950 Yale Ave Suite 29 Wallingford CT 06492-1858 Ph: (203) 793-7147 |
| NPI Number | 1164771424 |
|---|---|
| Provider Enumeration Date | 09/02/2012 |
| Last Update Date | 09/02/2012 |
| Medicare PECOS PAC ID | 2264681691 |
|---|---|
| Medicare Enrollment ID | O20120928000638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164771424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 001858 (Connecticut) | Primary |
| Provider Name | Stephanie Marie Bennett |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1902110919 PECOS PAC ID: 3173772506 Enrollment ID: I20121008000151 |
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