Provider Demographics
NPI:1992472476
Name:BENNETT, MAKENZIE (DPT)
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:
Last Name:BENNETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 PIPER ST STE C
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-8263
Mailing Address - Country:US
Mailing Address - Phone:501-463-9057
Mailing Address - Fax:866-632-2934
Practice Address - Street 1:117 PIPER ST STE C
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-8263
Practice Address - Country:US
Practice Address - Phone:501-463-9057
Practice Address - Fax:666-322-9348
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT-50132251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic