Provider Demographics
NPI:1427236389
Name:BENNETT-BECKLEY, MOLLY ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ELIZABETH
Last Name:BENNETT-BECKLEY
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2585 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25703-1642
Mailing Address - Country:US
Mailing Address - Phone:304-697-1396
Mailing Address - Fax:304-697-2086
Practice Address - Street 1:71 WAYNE ST
Practice Address - Street 2:
Practice Address - City:FORT GAY
Practice Address - State:WV
Practice Address - Zip Code:25514-8518
Practice Address - Country:US
Practice Address - Phone:304-648-5544
Practice Address - Fax:304-648-5989
Is Sole Proprietor?:No
Enumeration Date:2008-02-03
Last Update Date:2020-11-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant