MEDICARE: CAROLYN S BENTLEY P.T, D.P.T., M.ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	3534	MA

General Provider Information

NPI Number	:	1720377948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN S BENTLEY P.T, D.P.T., M.ED

Provider Business Mailing Address
First Line	:	24 N PROSPECT ST
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-2014
Country	:	US
Telephone Number	:	413-256-0240
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 N PROSPECT ST
Second Line	:
City	:	AMHERST
State	:	MA
Zip	:	01002-2014
Country	:	US
Telephone Number	:	413-256-0240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2011
Last Update Date	:	03/29/2011

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