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NPI Code Detail

MEDICARE: MRS. TERRY JO ANN BENKO PT

MEDICARE: MRS. TERRY JO ANN BENKO 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 TherapistPT12685CA

General Provider Information

NPI Number : 1194841551
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERRY JO ANN BENKO PT
Provider Business Mailing Address
First Line : 1078 LOS OSOS VALLEY RD
Second Line :
City : LOS OSOS
State : CA
Zip : 93402-3237
Country : US
Telephone Number : 805-528-1190
Fax Number : 805-528-1378
Provider Business Practice Location Address
First Line : 1078 LOS OSOS VALLEY RD
Second Line :
City : LOS OSOS
State : CA
Zip : 93402-3237
Country : US
Telephone Number : 805-528-1190
Fax Number : 805-528-1378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. TERRY JO ANN BENKO PT” Practice Location

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