JACOB ERIC BENTLEY

HIRAM, GA
NPI1417127432
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy222Z00000X Orthotist
(Licence: GA  14)
Enumeration Date2008-03-05
Last Update Date2011-07-01
Business Address
-- JACOB ERIC BENTLEY CO, LO
127 ENTERPRISE PATH STE 403
HIRAM, GA 30141-2697
Phone number: 678-384-1921
Mailing Address
-- JACOB ERIC BENTLEY CO, LO
1619 JOHN ORR DR
TIFTON, GA 31794-3640
Phone number: 229-386-9829