Individual
MR. ROBERT L BENNETT III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
613 WINIFRED RD, LEESBURG, GA 31763-5342
(662) 497-2701
Mailing address
613 WINIFRED RD, LEESBURG, GA 31763-5342
(662) 497-2701
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005877
GA
Other
Enumeration date
01/02/2007
Last updated
08/14/2020
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