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Individual

MR. JOSHUA BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RD

Contact information

Practice address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 880-2447
(586) 427-4921
Mailing address
21230 DEQUINDRE RD, WARREN, MI 48091-2279
(586) 880-2447
(586) 427-4921

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86053205
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
404554179
MI
Enumeration date
08/22/2017
Last updated
08/22/2017
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