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1295258705
GARY DALE BENNETT
LOUISVILLE, KY
NPI
1295258705
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32003204A)
Enumeration Date
2017-07-18
Last Update Date
2018-03-17
Business Address
GARY DALE BENNETT COTA
2701 CHESTNUT STATION CT
LOUISVILLE, KY 40299-6395
Phone number: 800-335-1060
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Mailing Address
GARY DALE BENNETT COTA
4051 CREEK WAY APT 45
INDIANAPOLIS, IN 46227-4046
Phone number: 317-865-1335
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