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Individual

MICHAEL AARON BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPS

Contact information

Practice address
190 MATCH FACTORY PL, BELLEFONTE, PA 16823-1367
(814) 353-3151
(814) 355-2247
Mailing address
190 MATCH FACTORY PL, BELLEFONTE, PA 16823-1367
(814) 353-3151
(814) 355-2247

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PA

Other

Enumeration date
09/14/2018
Last updated
09/14/2018
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