Individual
STACY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 S LAKEVIEW CT, GODDARD, KS 67052-9228
(316) 252-0445
Mailing address
1446 N CEDAR PARK CIR, WICHITA, KS 67235-1209
(131) 673-4177
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-01941
KS
Other
Enumeration date
06/03/2022
Last updated
06/03/2022
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