MEDICARE: MR. BENJAMIN ALIKA ERBE D.P.T.

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
1	2251X0800X	Orthopedic Physical Therapist	12459PT	AZ

General Provider Information

NPI Number	:	1770038028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN ALIKA ERBE D.P.T.

Provider Business Mailing Address
First Line	:	1222 N ELM CT
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-2372
Country	:	US
Telephone Number	:	913-553-7838
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 E BROADWAY RD STE 130
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-8809
Country	:	US
Telephone Number	:	602-437-0234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	08/16/2016

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