Individual
LEAH DIONNE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 GEORGE ST, BECKLEY, WV 25801-2648
(404) 929-2670
Mailing address
130 GEORGE ST, BECKLEY, WV 25801-2648
(304) 929-2670
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
F886734
WV
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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