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Individual

MR. JOSEPH L BENTLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1051 SCOTTSVILLE ROAD, LAFAYETTE, TN 37083
(615) 666-6613
(615) 666-8179
Mailing address
PO BOX 296, LAFAYETTE, TN 37083
(615) 666-6613
(615) 666-8179

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
5541646
TN
152W00000X
Optometrist
Primary
TOD1237
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1452031
TN
Enumeration date
05/27/2006
Last updated
06/02/2008
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