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Individual

STEVEN FREDERICK BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
636 W BROADWAY ST, NORTH LITTLE ROCK, AR 72114-5526
(501) 374-1153
(501) 374-6213
Mailing address
636 W BROADWAY ST, NORTH LITTLE ROCK, AR 72114-5526
(501) 374-1153
(501) 374-6213

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
992
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
152197718
AR
01
1801872304
GROUP NPI
AR
01
350052757
RAILROAD MEDICARE ID #
AR
Enumeration date
12/16/2005
Last updated
08/22/2011
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