Individual
DR. MATTHEW P. BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
215 E MAIN ST, NEOSHO, MO 64850-1812
(417) 451-4200
Mailing address
215 E MAIN ST, NEOSHO, MO 64850-1812
(417) 451-4200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2001001758
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000026034
MEDICARE PTAN
MO
Enumeration date
10/17/2006
Last updated
08/29/2011
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