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Individual

JANITA RENEE BENNETT X

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17562 FREELAND ST, DETROIT, MI 48235-2569
(313) 917-6231
Mailing address
17562 FREELAND ST, DETROIT, MI 48235-2569
(313) 917-6231
(313) 397-7196

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B900000543675
MI

Other

Enumeration date
01/31/2023
Last updated
02/09/2023
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