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1366161887
BRADEN BENNETT
IDAHO FALLS, ID
NPI
1366161887
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: ID PT-8106)
Enumeration Date
2022-08-26
Last Update Date
2022-08-26
Business Address
BRADEN BENNETT PT, DPT
3100 S WOODRUFF AVE
IDAHO FALLS, ID 83404-8310
Phone number: 208-523-8879
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Mailing Address
BRADEN BENNETT PT, DPT
5267 BARTON PL
AMMON, ID 83406-5047
Phone number: 208-705-0324
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