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General NPI Number Information
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NPI Number | 1720821721
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Entity Type | Individual
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Provider Name | BENJAMIN TRISTAN HIGGINS DPT
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Gender | Male
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 07/21/2024
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Provider Practice Location Address
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Address Line | 3604 LANCASTER PIKE STE A
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City | WILMINGTON
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State | DE
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Zip | 19805-1600
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Country | US
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Telephone | 302-691-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 909 CEDARTREE LN APT 10
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City | CLAYMONT
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State | DE
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Zip | 19703-1665
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Country | US
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Telephone | 609-553-3441
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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 |
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License Number State |
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