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NPI Code Detail

MEDICARE: DR. DERRICK JAMES BENNER D.C.

MEDICARE: DR. DERRICK JAMES BENNER D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor007451IA

General Provider Information

NPI Number : 1194006189
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DERRICK JAMES BENNER D.C.
Provider Business Mailing Address
First Line : 3321 CEDAR HEIGHTS DR
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-6041
Country : US
Telephone Number : 319-277-1819
Fax Number : 319-277-1907
Provider Business Practice Location Address
First Line : 3321 CEDAR HEIGHTS DR
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-6041
Country : US
Telephone Number : 319-277-1819
Fax Number : 319-277-1907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2011
Last Update Date : 03/25/2026

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