Individual
DR. KURT JACOB BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
14428 WHITE BIRCH VALLEY LN, CHESTERFIELD, MO 63017-2416
(812) 606-9500
Mailing address
14428 WHITE BIRCH VALLEY LN, CHESTERFIELD, MO 63017-2416
(812) 606-9500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2013032691
MO
152W00000X
Optometrist
Primary
TA2391
MD
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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