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Individual

BLAKE BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
871 RIDGEWAY LOOP RD STE 100, MEMPHIS, TN 38120-4026
(901) 266-3838
Mailing address
871 RIDGEWAY LOOP RD STE 100, MEMPHIS, TN 38120-4026

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
13112
TN

Other

Enumeration date
11/03/2020
Last updated
12/09/2021
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