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General NPI Number Information
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NPI Number | 1952311417
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Entity Type | Organization
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Legal Business Name | BENNITT PATTERSON PA
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 2010 N YOUNG BLVD
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City | CHIEFLAND
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State | FL
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Zip | 32626-1951
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Country | US
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Telephone | 352-493-1540
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Fax | 352-493-1628
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Provider Business Mailing Address
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Address Line | PO BOX 1027
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City | CHIEFLAND
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State | FL
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Zip | 32644-1027
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Country | US
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Telephone | 352-493-1540
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Fax | 352-493-1628
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENNITT C PATTERSON
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Credential | D.C.
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Telephone | 352-493-1540
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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 | CH6495
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License Number State | FL
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