Healthcare Provider Details

I. General information

NPI: 1427802487
Provider Name (Legal Business Name): ANTHONY BENACCI PALLOTO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BENACCI PALLOTO DC

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W MAPLEWOOD LN
NASHVILLE TN
37207-2981
US

IV. Provider business mailing address

1501 NORVEL AVE
NASHVILLE TN
37216-3313
US

V. Phone/Fax

Practice location:
  • Phone: 724-678-2272
  • Fax:
Mailing address:
  • Phone: 724-678-2272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number0000003818
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: