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Individual

DR. MARCY LYNN BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.C.

Contact information

Practice address
9961 WINGHAVEN BLVD, O FALLON, MO 63368-3623
(636) 265-2566
Mailing address
9961 WINGHAVEN BLVD, O FALLON, MO 63368-3623
(636) 265-2566
(866) 418-4148

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2000144756
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139154
BLUE CROSS BLUE SHIELD
MO
01
38309
GHP CMR PROVIDER NUMBER
MO
01
432179
HEALTHLINK PROVIDER NUMBE
MO
01
4401175
UNTIED HEALTHCARE PROVIDE
MO
Enumeration date
02/03/2007
Last updated
03/31/2022
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