Individual
MARK BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2766 W 11 MILE RD STE 2, BERKLEY, MI 48072-3033
(248) 542-2424
Mailing address
11435 MERCEDES, REDFORD, MI 48239-2377
(313) 748-2859
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
4703085015
MI
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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