Tina Bennett Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9317 Issued in FL

Legal business name

TINA BENNETT CHIROPRACTIC, INC.

Practice address

3729 S Nova Rd
Port Orange, FL 32129-4233

Phone

(386) 761-0520

Fax

(386) 761-0553

NPI assigned

Dec 7, 2010

Last updated

Dec 7, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Crystal L Young

Title

Office Manager

Phone

(386) 761-0520

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1245533603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3729 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294233",
            "telephone_number": "386-761-0520",
            "fax_number": "386-761-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3729 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294233",
            "telephone_number": "386-761-0520",
            "fax_number": "386-761-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINA BENNETT CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-07",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-761-0520",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.