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NPI Code Detail

MEDICARE: ANGELA BENSON PT

MEDICARE: ANGELA BENSON PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist002495WV

General Provider Information

NPI Number : 1083714059
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA BENSON PT
Provider Business Mailing Address
First Line : 37 MILL CREEK XING
Second Line :
City : HURRICANE
State : WV
Zip : 25526-8701
Country : US
Telephone Number : 304-389-5826
Fax Number :
Provider Business Practice Location Address
First Line : 300 SEVILLE RD
Second Line :
City : HURRICANE
State : WV
Zip : 25526-9206
Country : US
Telephone Number : 304-757-6805
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 11/29/2012

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