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Individual

KAYLA AMBRIA BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
12100 PRINCELAND SPUR, ASHLAND, KY 41102-7883
(606) 928-2963
Mailing address
1917 WOODLAND DR, IRONTON, OH 45638-2347
(606) 232-1613

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A03151
KY
225200000X
Physical Therapy Assistant
PTA.09313
OH

Other

Enumeration date
01/18/2016
Last updated
01/18/2016
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