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General NPI Number Information
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NPI Number | 1790825149
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Entity Type | Individual
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Provider Name | CHRISTOPHER DALE BENNETT D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3018 SOUTH MALL ROAD
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City | KNOXVILLE
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State | TN
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Zip | 37917
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Country | US
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Telephone | 865-566-0160
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Fax | 865-544-1718
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Provider Business Mailing Address
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Address Line | PO BOX 3187
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City | KNOXVILLE
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State | TN
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Zip | 37927-3187
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Country | US
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Telephone | 865-566-0160
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Fax | 865-544-1718
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC0000001127
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License Number State | TN
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