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General NPI Number Information
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NPI Number | 1205582673
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Entity Type | Individual
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Provider Name | COURTENEY BENCK PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 03/01/2022
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Provider Practice Location Address
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Address Line | 141 HAMPTON CIR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4103
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Country | US
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Telephone | 248-853-7555
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Fax | 248-853-7556
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Provider Business Mailing Address
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Address Line | 23300 HARRELLSON ST
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City | MACOMB
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State | MI
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Zip | 48042-5463
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Country | US
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Telephone | 810-358-5585
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501301879
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License Number State | MI
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