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General NPI Number Information
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NPI Number | 1003437252
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Entity Type | Individual
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Provider Name | JOSEPH CHASE BENNETT
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Gender | Male
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 700 SOUTH 19TH STREET 8305A - OFFICE
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City | BIRMINGHAM
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State | AL
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Zip | 35233
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Country | US
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Telephone | 205-933-8101
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Fax |
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Provider Business Mailing Address
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Address Line | 910 GRIFFIN PARK CIR
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City | BIRMINGHAM
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State | AL
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Zip | 35242-7099
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Country | US
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Telephone | 256-453-3328
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5037
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License Number State | AL
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