Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB ERIC BENTLEY, CO, LO
ActiveJACOB ERIC BENTLEY, CO, LO is a Orthotist healthcare provider located in HIRAM, Georgia. NPI 1417127432 is currently active in the NPPES registry. Verify at CMS.
Orthotist · HIRAM, GA
Registration Details
- NPI Number
- 1417127432
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 5, 2008 (18.462795535362 yrs)
- Last Updated
- Jul 1, 2011
- License
-
14 (GA)
Practice Information
- Address
-
127 ENTERPRISE PATHSTE 403HIRAM, GA, 301412697Browse GA providers · Browse ZIP 30141
- Phone
- 6783841921
- Fax
- 6783841922
- Primary Specialty
-
Orthotist
222Z00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.