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General NPI Number Information
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NPI Number | 1841025806
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Entity Type | Individual
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Provider Name | JOSHUA WALTER BENNETT PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/07/2024
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 3106 S W S YOUNG DR STE A102
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City | KILLEEN
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State | TX
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Zip | 76542-2000
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Country | US
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Telephone | 254-628-8391
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Fax |
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Provider Business Mailing Address
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Address Line | 328 BOGHT RD
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City | WATERVLIET
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State | NY
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Zip | 12189-1105
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Country | US
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Telephone | 518-225-0904
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 27956
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 052527
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1403051
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License Number State | TX
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