Individual
DANIEL COLEMAN BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4120
(715) 847-2121
Mailing address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4120
(715) 847-2121
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5006-33
WI
Other
Enumeration date
09/05/2012
Last updated
02/15/2013
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