Individual
MS. VANESSA R BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002709
WV
225100000X
Physical Therapist
21341
MD
225100000X
Physical Therapist
2305204519
VA
Other
Enumeration date
10/04/2005
Last updated
10/07/2010
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