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NPI Code Detail

MEDICARE: MS. BREANNA BENJAMIN PT

MEDICARE: MS. BREANNA BENJAMIN 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 TherapistPT.013428OH

General Provider Information

NPI Number : 1316281736
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BREANNA BENJAMIN PT
Provider Business Mailing Address
First Line : 2178 COUNTY ROAD B
Second Line :
City : SWANTON
State : OH
Zip : 43558-9750
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 401 W AIRPORT HWY
Second Line :
City : SWANTON
State : OH
Zip : 43558-1445
Country : US
Telephone Number : 419-825-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2012
Last Update Date : 11/26/2012

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Directions to “ MS. BREANNA BENJAMIN PT” Practice Location

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