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1225091705
KRISTA R BENNETT
FORT WAYNE, IN
NPI
1225091705
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
204C00000X Neuromusculoskeletal Medicine, Sports Medicine
(Licence: IN 36000834A)
Enumeration Date
2006-04-07
Last Update Date
2007-07-08
Business Address
Mrs. KRISTA R BENNETT LAT, ATC
5050 N CLINTON ST
FORT WAYNE, IN 46825-5822
Phone number: 260-484-8551
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Mailing Address
Mrs. KRISTA R BENNETT LAT, ATC
726 SUNTURN DR
FORT WAYNE, IN 46825-2295
Phone number: 260-497-9529
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