Individual
MR. KEVIN RICHARD BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2250 HICKORY RD STE 240, PLYMOUTH MEETING, PA 19462-2225
(570) 524-0900
Mailing address
24 BOGAR LN, MIFFLINBURG, PA 17844-1404
(570) 966-1254
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
RN517145L
PA
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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