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1619551165
JOLENE LARAE BENNETT
GRANDVILLE, MI
NPI
1619551165
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: MI 5501003994)
Enumeration Date
2021-05-11
Last Update Date
2021-05-11
Business Address
JOLENE LARAE BENNETT PT
3540 FAIRLANES AVE SW
GRANDVILLE, MI 49418-1536
Phone number: 616-531-0464
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Mailing Address
JOLENE LARAE BENNETT PT
3540 FAIRLANES AVE SW
GRANDVILLE, MI 49418-1536
Phone number: 616-531-0464
Copy
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