LOREN WALLACE BENNETT

MOUNTAIN HOME, TN
NPI1215989603
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: TN  1409)
Additional Taxonomies152W00000X Optometrist
(Licence: OH  4003)
Enumeration Date2006-05-16
Last Update Date2008-07-08
Business Address
DR. LOREN WALLACE BENNETT O.D., M.P.H.
JAMES H. QUILLEN VAMC, SIDNEY/LAMONT ST EYE CLINIC 112E
MOUNTAIN HOME, TN 37684
Phone number: 423-926-1171
Mailing Address
DR. LOREN WALLACE BENNETT O.D., M.P.H.
PO BOX 4000 EYE CLINIC 112E
MOUNTAIN HOME, TN 37684-4000
Phone number: 423-926-1171