Micah Bennett

NPI #1316326143 in Pleasant Valley, New York

Provider Information

NPI Number: 1316326143
Entity Type: Individual
Name: Micah Bennett
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: May 26, 2015
Last Updated: May 26, 2015

Practice Location

Address: 1372 ROUTE 44
Address 2: BUILDING #2
City: Pleasant Valley
State: New York
ZIP Code: 12569-7811
Phone: (845) 518-4827

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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