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General NPI Number Information
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NPI Number | 1699923110
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Entity Type | Organization
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Legal Business Name | BENNETT CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 501 S HARPER ST
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City | LAURENS
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State | SC
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Zip | 29360-2802
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Country | US
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Telephone | 864-984-6731
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Fax | 864-983-1278
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Provider Business Mailing Address
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Address Line | 501 S HARPER ST P O BOX 218
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City | LAURENS
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State | SC
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Zip | 29360-2802
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Country | US
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Telephone | 864-984-6731
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Fax | 864-983-1278
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Authorized Official
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Title or Position | DOCTOR/OWNER OF BUSINESS
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Name | DR. DARRELL MITCHELL DAVIS
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Credential | DOCTOR OF CHIROPRACT
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Telephone | 864-984-6731
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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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