Individual
MRS. DIANE M BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2140 JFK RD, STE F, DUBUQUE, IA 52002-3883
(563) 582-0769
(563) 582-5772
Mailing address
200 N MAIN ST, POTOSI, WI 53820-9413
(608) 763-2744
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
01/26/2006
Last updated
02/20/2015
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