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General NPI Number Information
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NPI Number | 1174812200
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Entity Type | Organization
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Legal Business Name | PATRICK M BENNETT D C A CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 03/29/2011
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 4409 TUJUNGA AVE
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City | STUDIO CITY
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State | CA
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Zip | 91602-2053
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Country | US
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Telephone | 818-766-0118
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Fax | 818-766-0078
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Provider Business Mailing Address
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Address Line | 4409 TUJUNGA AVE
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City | STUDIO CITY
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State | CA
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Zip | 91602-2053
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Country | US
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Telephone | 818-766-0118
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Fax | 818-766-0078
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. PATRICK MICHAEL BENNETT
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Credential |
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Telephone | 818-766-0118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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