Provider Demographics
NPI:1720377948
Name:BENTLEY, CAROLYN S (PT, DPT, MED)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:S
Last Name:BENTLEY
Suffix:
Gender:F
Credentials:PT, DPT, MED
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:STIGLIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:24 N PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-2014
Mailing Address - Country:US
Mailing Address - Phone:413-256-0240
Mailing Address - Fax:
Practice Address - Street 1:24 N PROSPECT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2014
Practice Address - Country:US
Practice Address - Phone:413-256-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist