Individual
SALLY S BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5900 E UNIVERSITY AVE, SUITE 100, PLEASANT HILL, IA 50327-8466
(515) 643-2400
(515) 643-4766
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-2400
(515) 643-4766
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001630
IA
Other
Enumeration date
03/17/2006
Last updated
03/29/2017
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