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Individual
MRS. KELLI DONAHUE BENTSEN
Active
Individual
MRS. KELLI DONAHUE BENTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT023939
PA
2251P0200X
Pediatric Physical Therapist
8753
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078K3
BCBS IND #
NC
05
—
7211010
—
NC
Enumeration date
02/02/2007
Last updated
07/23/2020
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