Individual
ERIC J BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMS
Contact information
Practice address
14574 US HIGHWAY 23, WAVERLY, OH 45690-9373
(740) 464-4473
Mailing address
178 GINAT DR, FRANKLIN FURNACE, OH 45629-8822
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
163W00000X
Registered Nurse
Primary
314669
OH
Other
Enumeration date
01/30/2019
Last updated
01/21/2020
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