Individual
MRS. DAYNA GAIL BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
7316 27TH AVE, KENOSHA, WI 53143-5284
(262) 605-9204
Mailing address
7316 27TH AVE, KENOSHA, WI 53143-5284
(262) 605-9204
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/04/2008
Last updated
11/04/2008
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