Individual
MR. DANIEL ERIC BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 S. MAIN ST, WATTS, OK 74964
(918) 422-4888
Mailing address
547 NIRK AVE, SAINT LOUIS, MO 63122-5624
(314) 583-9033
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
01/23/2013
Last updated
01/29/2013
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