Healthcare Provider Details

I. General information

NPI: 1487569059
Provider Name (Legal Business Name): VICTORIA H BENSON PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 RED RIVER AVE N STE 6
COLD SPRING MN
56320-1523
US

IV. Provider business mailing address

19946 BEAVER LAKE RD
SAINT AUGUSTA MN
55353-9712
US

V. Phone/Fax

Practice location:
  • Phone: 320-685-7269
  • Fax:
Mailing address:
  • Phone: 320-292-4872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA3186
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: