Individual
CASEY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5717 OAKLAND DR, PORTAGE, MI 49024-1116
(269) 459-6212
Mailing address
5717 OAKLAND DR, PORTAGE, MI 49024-1116
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501016762
MI
Other
Enumeration date
10/03/2014
Last updated
10/03/2014
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