Individual
KATHERINE D BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
734 BIG TREE RD, SOUTH DAYTONA, FL 32119-2754
(386) 334-6612
Mailing address
734 BIG TREE RD, SOUTH DAYTONA, FL 32119-2754
(386) 334-6612
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0022040
FL
Other
Enumeration date
10/29/2011
Last updated
10/29/2011
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