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General NPI Number Information
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NPI Number | 1497802680
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Entity Type | Organization
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Legal Business Name | DR CRAIG A. BENSON CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17791 FJORD DR NE STE 214
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City | POULSBO
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State | WA
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Zip | 98370-8481
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Country | US
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Telephone | 360-779-9957
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Fax | 360-779-5848
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Provider Business Mailing Address
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Address Line | PO BOX 1893
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City | POULSBO
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State | WA
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Zip | 98370-0270
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Country | US
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Telephone | 360-779-9957
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Fax | 360-779-5848
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRAIG AULD BENSON
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Credential | DC
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Telephone | 360-779-9957
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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 | 2079
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License Number State | WA
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