Healthcare Provider Details

I. General information

NPI: 1114965704
Provider Name (Legal Business Name): BENTON FRANKLIN ORTHOPEDIC ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 W GAGE BLVD
KENNEWICK WA
99336-8113
US

IV. Provider business mailing address

8200 W GAGE BLVD
KENNEWICK WA
99336-8113
US

V. Phone/Fax

Practice location:
  • Phone: 509-586-2828
  • Fax: 509-586-2525
Mailing address:
  • Phone: 509-586-2828
  • Fax: 509-586-2525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL NEITZEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 509-586-2828