Organization
GRANT D. BENNETT
Active
Other names
Bennett Mobility Products
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT D. BENNETT (OWNER/MANAGER/TECHNICIAN)
(912) 614-2269
Entity
Organization
Contact information
Practice address
6223 CLARK RD., BLACKSHEAR, GA 31516
(912) 807-6625
(912) 807-0212
Mailing address
6223 CLARK RD., BLACKSHEAR, GA 31516
(912) 807-6625
(912) 807-0212
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003108583A
—
GA
05
—
879144878A
—
GA
Enumeration date
05/16/2008
Last updated
04/25/2019
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