Individual
ZACHERY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
343 WALLER AVE, STE 201, LEXINGTON, KY 40504-2912
(859) 475-8407
(859) 272-6893
Mailing address
343 WALLER AVE, STE 201, LEXINGTON, KY 40504-2912
(859) 475-8407
(859) 272-6893
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30608012
—
KY
Enumeration date
10/04/2011
Last updated
06/08/2016
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