Individual
MS. ANNETTE D BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1061 E MAIN ST, STE 204, GRASS VALLEY, CA 95945-5724
(530) 274-2274
(530) 274-2559
Mailing address
1061 E MAIN ST, STE 204, GRASS VALLEY, CA 95945-5724
(530) 274-2274
(530) 274-2559
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11955
CA
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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