Individual
BENJAMIN BRADLEY JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 S. MARION AVE, PM & RS OT, LAKE CITY, FL 32025
(386) 755-3016
Mailing address
119 ORANGE AVE, LEESBURG, FL 34748-5138
(989) 882-7305
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16231
FL
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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