MEDICARE: DR. JARRETT JAMES BENAWAY DC

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	2301401233	MI

General Provider Information

NPI Number	:	1396493151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARRETT JAMES BENAWAY DC

Provider Business Mailing Address
First Line	:	6620 BROOKLYN RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-9227
Country	:	US
Telephone Number	:	517-536-7058
Fax Number	:	910-586-1588

Provider Business Practice Location Address
First Line	:	6620 BROOKLYN RD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-9227
Country	:	US
Telephone Number	:	517-536-7058
Fax Number	:	910-586-1588

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

Provider Enumeration Date	:	03/11/2022
Last Update Date	:	03/06/2025

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