Individual
MS. ALICIA MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, CPFS
Contact information
Practice address
340 LAMA ST., LANAI CITY, HI 96763-0630
(808) 559-6435
Mailing address
340 LAMA ST., LANAI CITY, HI 96763-0630
(808) 559-6435
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
HI
Other
Enumeration date
03/23/2006
Last updated
11/28/2012
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