Healthcare Provider Details

I. General information

NPI: 1932581410
Provider Name (Legal Business Name): AARON MICHAEL BENZINE DC, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W1185 MCCRAE RD
FALL RIVER WI
53932-9575
US

IV. Provider business mailing address

W1468 STATE ROAD 16
FALL RIVER WI
53932-9547
US

V. Phone/Fax

Practice location:
  • Phone: 920-484-6444
  • Fax:
Mailing address:
  • Phone: 920-350-2775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5516-12
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: