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General NPI Number Information
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NPI Number | 1457027922
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Entity Type | Organization
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Legal Business Name | BENSA CHIROPRACTIC AND WELLNESS
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 4618 E STATE ROAD 64
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City | BRADENTON
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State | FL
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Zip | 34208-9012
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Country | US
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Telephone | 386-295-7176
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Fax |
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Provider Business Mailing Address
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Address Line | 4618 E STATE ROAD 64
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City | BRADENTON
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State | FL
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Zip | 34208-9012
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Country | US
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Telephone | 386-295-7176
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NICOLE SANTANA RODRIGUEZ
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Credential | DC
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Telephone | 385-295-7176
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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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