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Organization

BENNETT CLINIC LLC

Active
Other names
Bennett Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WAYNE ANTHONY BENNETT D.C. (DIRECTOR)
(928) 771-9400
Entity
Organization

Contact information

Practice address
1202 WILLOW CREEK RD, PRESCOTT, AZ 86301-1428
(928) 771-9400
(928) 771-9464
Mailing address
1202 WILLOW CREEK RD, PRESCOTT, AZ 86301-1428
(928) 771-9400
(928) 771-9464

Taxonomy

Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
5009
AZ
261QP2000X
Physical Therapy Clinic/Center
Primary
PT 6078
AZ

Other

Enumeration date
02/08/2010
Last updated
03/06/2013
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