Individual
DR. JASON DAVID BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4850 ENCORE BLVD, MT PLEASANT, MI 48858-6013
(989) 772-1704
(989) 773-9406
Mailing address
4850 ENCORE BLVD, MT PLEASANT, MI 48858-6013
(989) 772-1704
(989) 773-9406
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004375
MI
Other
Enumeration date
07/27/2006
Last updated
06/30/2014
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