Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | DAPT000847 | PA |
NPI | 1265599005 |
---|---|
Provider Name | Nanette Bennett |
First Address | Pittsburgh, PA 15238-3126 |
Second Address | Pittsburgh, PA 15238-3126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 23/02/2016 |