Individual
BROOKE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28939 N 121ST LN, PEORIA, AZ 85383-3377
(248) 660-5661
Mailing address
28939 N 121ST LN, PEORIA, AZ 85383-3377
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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