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General NPI Number Information
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NPI Number | 1154244945
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Entity Type | Individual
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Provider Name | JARED BENSON
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Gender | Male
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 2001 W 86TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1902
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Country | US
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Telephone | 317-338-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 1342 N EWING ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46201-1432
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Country | US
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Telephone | 463-210-8232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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