Provider Demographics
NPI:1508752833
Name:BENNETT, BRIDGET MARIE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MARIE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 DUNBAR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-9413
Mailing Address - Country:US
Mailing Address - Phone:765-719-9292
Mailing Address - Fax:
Practice Address - Street 1:1903 DUNBAR HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:IN
Practice Address - Zip Code:46135-9413
Practice Address - Country:US
Practice Address - Phone:765-719-9292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT22408379225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist