Individual
ROBERT RUSSELL BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
21885 HIGHWAY 62, SHADY COVE, OR 97539
(541) 878-3603
(541) 878-3603
Mailing address
PO BOX 550, EAGLE POINT, OR 97524-0550
(541) 878-3603
(541) 878-3603
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2769
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043898
—
OR
Enumeration date
01/17/2007
Last updated
01/26/2022
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