BASIL BENNETT

LOGAN, WV
NPI1821724543
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
(Licence: WV  0072)
Enumeration Date2022-07-26
Last Update Date2022-07-26
Business Address
BASIL BENNETT
174 LMAH CENTER RD
LOGAN, WV 25601-4058
Phone number: 304-792-7130
Mailing Address
BASIL BENNETT
PO BOX 176
LOGAN, WV 25601-0176
Phone number: 304-792-7130