Individual
DR. LOREN WALLACE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D., M.P.H.
Contact information
Practice address
JAMES H. QUILLEN VAMC, SIDNEY/LAMONT ST, EYE CLINIC 112E, MOUNTAIN HOME, TN 37684
(423) 926-1171
(423) 979-3530
Mailing address
PO BOX 4000, EYE CLINIC 112E, MOUNTAIN HOME, TN 37684-4000
(423) 926-1171
(423) 979-3530
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1409
TN
152W00000X
Optometrist
4003
OH
Other
Enumeration date
05/16/2006
Last updated
07/08/2008
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