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Individual

DR. STACY LYNN BENNETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
13201 MAGISTERIAL DR, LOUISVILLE, KY 40223-4105
(502) 244-6770
Mailing address
3342 COMMODORE DR, APT. 471, LEXINGTON, KY 40502-3606
(859) 699-6222

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
37349
CA
2251X0800X
Orthopedic Physical Therapist
Primary
006269
KY

Other

Enumeration date
12/21/2010
Last updated
08/30/2013
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