Provider Demographics
NPI:1215946801
Name:BENSON CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:BENSON CHIROPRACTIC CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HORKAVY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-894-7120
Mailing Address - Street 1:PO BOX 475
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504
Mailing Address - Country:US
Mailing Address - Phone:919-894-7120
Mailing Address - Fax:919-207-1219
Practice Address - Street 1:202 N LEE ST
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504
Practice Address - Country:US
Practice Address - Phone:919-894-7120
Practice Address - Fax:919-207-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC790247FMedicaid
T64470Medicare UPIN
NC790247FMedicaid