Individual
SHELBY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
62 W RIVER DR, DURBIN, WV 26264-1104
(304) 456-5175
Mailing address
62 W RIVER DR, DURBIN, WV 26264-1104
(304) 456-5175
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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