| NPI | 1730403213 |
|---|---|
| Former Name | MARY E BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: KS 1101341) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MO RO919) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2010-03-26 |