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1780234146
THERON BENNETT
ELMIRA, NY
NPI
1780234146
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
3747A0650X Technician, Attendant Care Provider
Enumeration Date
2019-09-18
Last Update Date
2019-09-18
Business Address
THERON BENNETT
900 WEST FIRST STREET
ELMIRA, NY 14905
Phone number: 607-333-6322
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Mailing Address
THERON BENNETT
900 WEST FIRST STREET
ELMIRA, NY 14905
Phone number: 607-333-6322
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