Individual
MISS KAYLA ANN BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1400 MARK DR, WAHOO, NE 68066-4023
(402) 443-7394
Mailing address
243 W 3RD ST, WAHOO, NE 68066-1811
(402) 443-7394
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1306
NE
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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