Individual
STEPHANIE R BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
1815 N CAPITOL AVE, SUITE 600, INDIANAPOLIS, IN 46202-1288
(317) 924-8636
(317) 921-0237
Mailing address
1815 N CAPITOL AVE, SUITE 600, INDIANAPOLIS, IN 46202-1288
(317) 924-8636
(317) 921-0237
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001611A
IN
Other
Enumeration date
06/23/2011
Last updated
06/23/2011
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