Individual
MR. JEFFREY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
2826 RANDOLPH RD, CHARLOTTE, NC 28211-1386
(704) 366-5521
Mailing address
5068 GATES DR, DENVER, NC 28037-9636
(704) 483-1662
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1305
SC
2255A2300X
Athletic Trainer
Primary
1724
NC
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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