Individual
ELIJAH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3021 FRANKLIN AVE, RIVERSIDE, CA 92507-3337
(951) 358-7805
Mailing address
3681 CRANFORD AVE APT 25, RIVERSIDE, CA 92507-4551
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/04/2025
Last updated
08/05/2025
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