DOUGLAS NOLAND BENNETT

ADVANCE SPORTS AND SPINE THERAPY, LLC

Dr DOUGLAS NOLAND BENNETT is a male medical professional, specializing in Physical Therapy. He graduated in 2017.

Contact

ADVANCE SPORTS AND SPINE THERAPY, LLC

1554 GARDEN ST
SUITE 103
WEST LINN
OR
970683278

Tel: 5035821073

DOUGLAS NOLAND BENNETT Information

Npi 1770083446
Pac Id 4587927157
Professional Enrollment Id I20180412001049
Last Name BENNETT
First Name DOUGLAS
Middle Name NOLAND
Suffix
Gender M
Credential
Medical School Name OTHER
Graduation Year 2017
Primary Specialty PHYSICAL THERAPY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name ADVANCE SPORTS AND SPINE THERAPY, LLC
Group Practice Pac Id 2567457104
Number Of Group Practice Members 10
Line 1 Street Address 1554 GARDEN ST
Line 2 Street Address SUITE 103
Marker Of Address Line 2 Suppression
City WEST LINN
State OR
Zip Code 970683278
Phone Number 5035821073
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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