MEDICARE: DR. LUKE ANDREW BENNETT D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4183	NC

General Provider Information

NPI Number	:	1104118488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUKE ANDREW BENNETT D.C.

Provider Business Mailing Address
First Line	:	201 MCCULLOUGH DR
Second Line	:	SUITE 160
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-3577
Country	:	US
Telephone Number	:	304-544-6548
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 MCCULLOUGH DR
Second Line	:	SUITE 160
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-3577
Country	:	US
Telephone Number	:	304-544-6548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2011
Last Update Date	:	03/02/2013

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