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NPI Code Detail

MEDICARE: DR. BENJAMIN LEPPEK DPT

MEDICARE: DR. BENJAMIN LEPPEK DPT
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 Therapist

General Provider Information

NPI Number : 1376213694
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN LEPPEK DPT
Provider Business Mailing Address
First Line : 411 PRAIRIE HEIGHTS DR STE 101
Second Line :
City : VERONA
State : WI
Zip : 53593-2238
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6674 RONALD REAGAN AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-2395
Country : US
Telephone Number : 603-556-6120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2021
Last Update Date : 09/17/2021

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