Doctor Name: | KERRI BENNETT |
NPI Number: | 1144386228 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSPT |
License Number: | 1136588 |
Business Practice Address: | 1701 S Washington St Kaufman, TX - 751423439 |
Business Phone Number: | 4695953737 |
Business Fax Number: | 9729325970 |
Mailing Address: | 119 Rolling Ridge Ln, CRANDALL |
State: | TX |
Postal Code: | 751145109 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/31/2006 |
NPI Last Update Date: | 10/15/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 1136588 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |