Individual
JOAN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(610) 648-1000
Mailing address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(610) 648-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA002787L
PA
Other
Enumeration date
05/25/2006
Last updated
08/31/2011
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