Individual
JESSE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1008 E 38TH ST, AUSTIN, TX 78705-1813
(413) 512-9184
Mailing address
1008 E. 38TH STREET, AUSTIN, TX 78705
(413) 512-9184
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
114460
TX
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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