Individual
ANGELA BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
14809 W 95TH ST, LENEXA, KS 66215-5220
(913) 894-6664
Mailing address
14809 W 95TH ST, LENEXA, KS 66215-5220
(913) 894-6664
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02986
KS
225200000X
Physical Therapy Assistant
2016008266
MO
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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