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General NPI Number Information
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NPI Number | 1437092764
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Entity Type | Organization
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Legal Business Name | CHINOOK CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 902 BLACKBURN ST STE D
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City | CODY
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State | WY
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Zip | 82414-8014
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Country | US
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Telephone | 307-587-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 902 BLACKBURN ST STE D
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City | CODY
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State | WY
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Zip | 82414-8014
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Country | US
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Telephone | 307-587-1234
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. BRENT W BENSON
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Credential | DC
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Telephone | 307-587-1234
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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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