Healthcare Provider Details

I. General information

NPI: 1639430457
Provider Name (Legal Business Name): WILLIAM A BENTLEY BOCP, CFO, CPA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 AFFONSO DR STE G
CARSON CITY NV
89706-7794
US

IV. Provider business mailing address

3717 HILLSBORO BLVD
FALLON NV
89406-4330
US

V. Phone/Fax

Practice location:
  • Phone: 775-882-4408
  • Fax: 775-882-1561
Mailing address:
  • Phone: 775-882-4408
  • Fax: 775-882-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: