Individual
MR. STANLEY W BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
202 SMOKETREE WAY, LOUISBURG, NC 27549-2165
(919) 496-6500
(919) 496-6500
Mailing address
237 EVESHAM CT, WAKE FOREST, NC 27587-6400
(919) 554-1534
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4175
NC
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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