Individual
MR. REX ROSS BENNETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22687 E CLIFF DR, SANTA CRUZ, CA 95062-5357
(831) 596-8866
Mailing address
22687 E CLIFF DR, SANTA CRUZ, CA 95062-5357
(831) 596-8866
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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