Individual
MR. JODY CARL BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4010 BIENVILLE BLVD UNIT E, OCEAN SPRINGS, MS 39564-5990
(228) 300-6001
(228) 300-6005
Mailing address
670 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 328-1012
(662) 328-1507
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11395R
LA
225100000X
Physical Therapist
Primary
PT3943
MS
Other
Enumeration date
04/27/2012
Last updated
08/10/2023
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