Individual provider · Type 1 NPI

Lara Bennett

Surgical Physician Assistant · Phoenix, AZ

NPI number 1407227465 Active

Practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X6229 (AZ)

Surgical Physician Assistant: Definition to come...

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About NPI 1407227465

Lara Bennett's National Provider Identifier is 1407227465, issued on Oct 15, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 15, 2015.