Provider Demographics
NPI:1316072895
Name:BENNETT, DAVID ANDREW (DOCTOR OF CHIROPRACT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANDREW
Last Name:BENNETT
Suffix:
Gender:
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 E COLORADO AVE PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:BLAND
Mailing Address - State:MO
Mailing Address - Zip Code:65014
Mailing Address - Country:US
Mailing Address - Phone:573-646-3215
Mailing Address - Fax:
Practice Address - Street 1:132 E COLORADO AVE
Practice Address - Street 2:
Practice Address - City:BLAND
Practice Address - State:MO
Practice Address - Zip Code:65014
Practice Address - Country:US
Practice Address - Phone:573-646-3215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO003580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T43196Medicare UPIN