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NPI Code Detail

MEDICARE: MS. LESLIE R BENEDICT PT

MEDICARE: MS. LESLIE R BENEDICT 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 Therapist05005780AIN

General Provider Information

NPI Number : 1972083061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LESLIE R BENEDICT PT
Provider Business Mailing Address
First Line : 6551 BRIARWOOD PL
Second Line :
City : ZIONSVILLE
State : IN
Zip : 46077-8541
Country : US
Telephone Number : 317-701-6572
Fax Number :
Provider Business Practice Location Address
First Line : 4904 WAR ADMIRAL DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46237-9737
Country : US
Telephone Number : 317-884-5746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2018
Last Update Date : 08/17/2018

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