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1124110739
JACK BENTLEY
MOBILE, AL
NPI
1124110739
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: AL PTH3594)
Enumeration Date
2006-09-29
Last Update Date
2007-07-08
Business Address
Mr. JACK BENTLEY P.T.
67 E MIDTOWN PARK
MOBILE, AL 36606-4141
Phone number: 251-476-1279
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Mailing Address
Mr. JACK BENTLEY P.T.
5757 DEERWOOD DR S
MOBILE, AL 36618-3004
Phone number: 251-344-8463
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