Individual
KELLY A BENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2701 MOOREFIELD RD, SPRINGFIELD, OH 45502-8207
(937) 399-6650
(937) 399-8558
Mailing address
2701 MOOREFIELD RD, SPRINGFIELD, OH 45502-8207
(937) 399-6650
(937) 399-8558
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
OH
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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