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General NPI Number Information
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NPI Number | 1629214457
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Entity Type | Individual
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Provider Name | BENJAMIN ROY HINCHCLIFF PT.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 134 EAST EDGEWOOD BLVD
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City | LANSING
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State | MI
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Zip | 48911
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Country | US
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Telephone | 517-882-1192
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Fax | 517-882-1193
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Provider Business Mailing Address
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Address Line | P.O. BOX 80572 OWEN PHYSICAL THERAPY
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City | LANSING
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State | MI
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Zip | 48908-0572
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Country | US
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Telephone | 517-882-1192
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Fax | 517-882-1193
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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 | 5501009176
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License Number State | MI
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