Individual
DR. GARY LANE BENEDICT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
112 N MAIN ST, MARISSA, IL 62257-1342
(618) 295-2268
Mailing address
112 N MAIN ST, MARISSA, IL 62257-1342
(618) 295-2268
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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