Individual
BRUCE ADAM BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
610 LINCOLN ST, CENTERVILLE, SD 57014-2040
(605) 563-2291
Mailing address
29614 461ST AVE, CENTERVILLE, SD 57014-6711
(605) 408-6452
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R024679
SD
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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