Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 116495 | AK |
NPI | 1215465612 |
---|---|
Provider Name | Chelsea Bennett |
First Address | Anchorage, AK 99515-3534 |
Second Address | Anchorage, AK 99515-3534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2017 |
Last Update Date | 30/05/2017 |