Individual
MATTHEW BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1178 FREMONT CT, ELKHART, IN 46516-9321
(574) 293-7000
Mailing address
1178 FREMONT CT, ELKHART, IN 46516-9321
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002949A
IN
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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