Individual
GREGORY BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14300 SW INDIANOLA RD, AUGUSTA, KS 67010-7640
(316) 371-3644
Mailing address
14300 SW INDIANOLA RD, AUGUSTA, KS 67010-7640
(316) 371-3644
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
KS
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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