Provider Demographics
NPI:1699941534
Name:BENSON, TIMOTHY E (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:E
Last Name:BENSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-5937
Mailing Address - Country:US
Mailing Address - Phone:303-777-7874
Mailing Address - Fax:303-962-9524
Practice Address - Street 1:70 BROADWAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-5937
Practice Address - Country:US
Practice Address - Phone:303-777-7874
Practice Address - Fax:303-962-9524
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008011447111N00000X
CO6485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor