Individual
ANDREA M. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
11430 N PORT WASHINGTON RD, MEQUON, WI 53092-3414
(262) 518-1900
Mailing address
11430 N PORT WASHINGTON RD, MEQUON, WI 53092-3414
(262) 518-1900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10196
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40438600
—
WV
Enumeration date
07/05/2006
Last updated
10/02/2025
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