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Organization
TINA BENNETT CHIROPRACTIC, INC.
Active
Organization
TINA BENNETT CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL L YOUNG (OFFICE MANAGER)
(386) 761-0520
Entity
Organization
Contact information
Practice address
3729 S NOVA RD, PORT ORANGE, FL 32129-4233
(386) 761-0520
(386) 761-0553
Mailing address
3729 S NOVA RD, PORT ORANGE, FL 32129-4233
(386) 761-0520
(386) 761-0553
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH9317
FL
Other
Enumeration date
12/07/2010
Last updated
12/07/2010
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