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General NPI Number Information
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NPI Number | 1770780504
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Entity Type | Organization
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Legal Business Name | BENASSI CHIROPRACTIC, P.A.
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 731 BIELENBERG DR SUITE 101
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City | WOODBURY
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State | MN
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Zip | 55125-1700
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Country | US
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Telephone | 651-578-9191
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Fax | 651-702-7499
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Provider Business Mailing Address
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Address Line | 731 BIELENBERG DR SUITE 101
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City | WOODBURY
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State | MN
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Zip | 55125-1700
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Country | US
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Telephone | 651-578-9191
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Fax | 651-702-7499
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GINA M. BENASSI
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Credential | D.C., F.A.C.O.
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Telephone | 651-578-9191
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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 | 2985
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License Number State | MN
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