Provider Demographics
NPI:1154972255
Name:BENNETT BUSINESS VENTURES
Entity type:Organization
Organization Name:BENNETT BUSINESS VENTURES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:443-521-7040
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:EAST NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21631-0025
Mailing Address - Country:US
Mailing Address - Phone:443-521-7040
Mailing Address - Fax:
Practice Address - Street 1:302 COLLINS AVE.
Practice Address - Street 2:
Practice Address - City:HURLOCK
Practice Address - State:MD
Practice Address - Zip Code:21643
Practice Address - Country:US
Practice Address - Phone:443-521-7040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-20
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty