| Derrick J. Benner, Inc | |
|
226 Brandilynn Blvd Cedar Falls IA 50613-7410 | |
| (319) 277-1819 | |
| (319) 277-1907 |
| Full Name | Derrick J. Benner, Inc |
|---|---|
| Speciality | Chiropractor |
| Location | 226 Brandilynn Blvd, Cedar Falls, Iowa |
| Authorized Official Name and Position | Derrick James Benner (PRESIDENT) |
| Authorized Official Contact | 3192438393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Derrick J. Benner, Inc 226 Brandilynn Blvd Cedar Falls IA 50613-7410 Ph: (319) 277-1819 | Derrick J. Benner, Inc 226 Brandilynn Blvd Cedar Falls IA 50613-7410 Ph: (319) 277-1819 |
| NPI Number | 1164703039 |
|---|---|
| Provider Enumeration Date | 09/06/2011 |
| Last Update Date | 09/06/2011 |
| Medicare PECOS PAC ID | 5496926487 |
|---|---|
| Medicare Enrollment ID | O20110923000132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164703039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 007451 (Iowa) | Secondary |
| 111N00000X | Chiropractor | 007451 (Iowa) | Primary |
| Provider Name | Derrick J Benner |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1194006189 PECOS PAC ID: 3577734565 Enrollment ID: I20110923000146 |
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