Individual
MR. GEORGE EARL BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7540 NORTH 19TH AVEN, 200, PHOENIX, AZ 85021
(888) 873-4221
Mailing address
7540 NORTH 19TH AVEN, 200 SYNERTX REHAB, PHOENIX, AZ 85021
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
116430
MO
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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