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General NPI Number Information
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NPI Number | 1790055184
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Entity Type | Organization
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Legal Business Name | BENKAY INC
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 375 NE 10TH AVE
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4456
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Country | US
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Telephone | 352-563-6471
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Fax | 352-563-5062
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Provider Business Mailing Address
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Address Line | 375 NE 10TH AVE
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-4456
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Country | US
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Telephone | 352-563-6471
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Fax | 352-563-5062
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL LAWRENCE BENNETT
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Credential | DC
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Telephone | 352-563-6471
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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 | CH5987
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License Number State | FL
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