Individual
REBECCA ANN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
552 E CARSON ST STE 104, CARSON, CA 90745-2897
(323) 867-6379
Mailing address
552 E CARSON ST STE 104, CARSON, CA 90745-2897
(323) 867-6379
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
KK257903
CA
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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