Organization
BROADWAY NECK AND BACK, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES BENNETT II (CHIROPRACTOR)
(316) 461-8397
Entity
Organization
Contact information
Practice address
5437 BROADWAY, MERRILLVILLE, IN 46410-1647
(219) 980-3509
Mailing address
5437 BROADWAY, MERRILLVILLE, IN 46410-1647
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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