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NPI Code Detail

MEDICARE: BENJAMIN JOBGEN PT

MEDICARE: BENJAMIN JOBGEN PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070-012986IL
2225100000XPhysical Therapist03351IA

General Provider Information

NPI Number : 1407824907
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENJAMIN JOBGEN PT
Provider Business Mailing Address
First Line : 850 43RD AVE STE 100
Second Line :
City : MOLINE
State : IL
Zip : 61265-8401
Country : US
Telephone Number : 309-743-2070
Fax Number : 309-743-2073
Provider Business Practice Location Address
First Line : 931 13TH AVE N
Second Line :
City : CLINTON
State : IA
Zip : 52732-5072
Country : US
Telephone Number : 563-243-7814
Fax Number : 563-243-2441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 10/02/2018

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Directions to “ BENJAMIN JOBGEN PT” Practice Location

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