Individual
CAROL JEAN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6475 WALL ST, SUITE 202, COLORADO SPRINGS, CO 80918-8337
(719) 265-6654
(719) 265-6650
Mailing address
6475 WALL ST, SUITE 202, COLORADO SPRINGS, CO 80918-8337
(719) 265-6654
(719) 265-6650
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
507482
CO
Other
Enumeration date
03/02/2013
Last updated
03/02/2013
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