Individual
TERRY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
152 SADDLESHOP ROAD, HILLTOP, WV 25855-0125
(304) 469-2966
Mailing address
PO BOX 125, HILLTOP, WV 25855-0125
(304) 469-2966
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1986
WV
Other
Enumeration date
01/02/2015
Last updated
01/02/2015
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