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Individual

VICTORIA BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6965 CUMBERLAND GAP PKWY, HARROGATE, TN 37752-8245
(423) 869-3611
Mailing address
1920 OLD SNOW HILL RD, DOWELLTOWN, TN 37059-2201
(615) 785-6967

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AM0700X
Medical Physician Assistant

Other

Enumeration date
06/22/2017
Last updated
06/22/2017
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