Individual
CHARLES HENRY BENTLAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 DONIPHAN DR, NEOSHO, MO 64850-9120
(417) 451-9450
Mailing address
4301 DONIPHAN DR, NEOSHO, MO 64850-9120
(417) 451-9450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27302
MO
Other
Enumeration date
04/30/2010
Last updated
04/30/2010
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