Cameron Bennett, PTA

Individual provider Active NPI Physical Therapy Assistant · Greenville, TX

NPI 1598965733 · NPPES record last updated Oct 19, 2018

Key facts

NPI
1598965733
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2081000 (TX)
Practice address
2023 Fairway St
Greenville, TX 75402-8120
Phone
(603) 391-5147
Fax
(855) 232-8604
NPI assigned
Jul 24, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2081000TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0898 NH
Physical Therapy Assistant 225200000X 2081000 TX Yes

Addresses

Primary practice location

2023 Fairway St
Greenville, TX 75402-8120

Mailing address

2023 Fairway St
Greenville, TX 75402-8120
Phone (603) 391-5147

Other providers in Greenville, TX

All providers in Greenville, TX · Physical Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.