Jacob Eric Bentley, CO, LO

NPI #1417127432 in Hiram, Georgia

Provider Information

NPI Number: 1417127432
Entity Type: Individual
Name: Jacob Eric Bentley, CO, LO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Orthotist
Credential: CO, LO
Enumeration Date: Mar 5, 2008
Last Updated: Jul 1, 2011

Practice Location

Address: 127 ENTERPRISE PATH
Address 2: STE 403
City: Hiram
State: Georgia
ZIP Code: 30141-2697
Phone: (678) 384-1921

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthotist	222Z00000X	Primary

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