Individual
JEREMIAH BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
106 GARY ANN LN, DARBY, MT 59829-8601
(530) 559-1317
Mailing address
PO BOX 254, DARBY, MT 59829-0254
(530) 559-1317
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-27033
MT
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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