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NPI Code Detail

MEDICARE: LAURA BENNETT P.A.

MEDICARE: LAURA BENNETT P.A.
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
1363AM0700XMedical Physician Assistant267MT

General Provider Information

NPI Number : 1023010717
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA BENNETT P.A.
Provider Business Mailing Address
First Line : PO BOX 6369
Second Line :
City : HELENA
State : MT
Zip : 59604-6369
Country : US
Telephone Number : 406-447-2823
Fax Number : 406-447-2825
Provider Business Practice Location Address
First Line : 3330 PTARMIGAN LN
Second Line :
City : HELENA
State : MT
Zip : 59602-0521
Country : US
Telephone Number : 406-457-4180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 07/28/2016

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Directions to “ LAURA BENNETT P.A.” Practice Location

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