Individual
SHANNON MARIE BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 MIDWAY LOOP, ELKINS, WV 26241-1373
(304) 636-5252
Mailing address
27 MIDWAY LOOP, ELKINS, WV 26241-1373
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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