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1407227465
LARA BENNETT
PHOENIX, AZ
NPI
1407227465
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: AZ 6229)
Enumeration Date
2015-10-15
Last Update Date
2015-10-15
Business Address
-- LARA BENNETT
2601 E ROOSEVELT ST
PHOENIX, AZ 85008-4973
Phone number: 623-344-6700
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Mailing Address
-- LARA BENNETT
2929 E THOMAS RD
PHOENIX, AZ 85016-8034
Phone number: 602-470-5043
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