Individual
KATHRYN MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
322 S MAIN ST, EMPORIA, VA 23847-2028
(434) 634-4428
(434) 634-9183
Mailing address
PO BOX 386, EMPORIA, VA 23847-0386
(434) 634-3138
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001192
VA
111N00000X
Chiropractor
3500
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106208
ANTHEM PROVIDER NUMBER
VA
01
—
301459
ANTHEM
VA
Enumeration date
09/16/2005
Last updated
10/04/2007
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