Individual
DOUGLAS RYAN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1400 EDWARDS MILL RD, RALEIGH, NC 27607-3624
(919) 861-2308
Mailing address
1400 EDWARDS MILL RD, RALEIGH, NC 27607-3624
(919) 412-5466
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1090
NC
Other
Enumeration date
07/26/2006
Last updated
07/30/2024
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