DANIEL A BENTLEY

ROCKFORD, IL
NPI1629177647
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: IL  085.004313)
Additional Taxonomies363AS0400X Physician Assistant, Surgical
(Licence: FL  PA9104555)
Enumeration Date2006-09-22
Last Update Date2013-06-28
Business Address
-- DANIEL A BENTLEY PA
1401 E STATE ST
ROCKFORD, IL 61104-2315
Phone number: 815-391-6102
Mailing Address
-- DANIEL A BENTLEY PA
95 COLLIER RD SUITE 5015
ATLANTA, GA 30309
Phone number: 404-605-2800