Benjamin, Bethany Lynn

Benjamin, Bethany Lynn is an individual health care provider with primary practice located at 5821 State Highway 34 , Rudolph WI 54475-9587. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Benjamin, Bethany Lynn can be contacted via phone (715) 459-5255.

Contact Information

Primary practice address
5821 State Highway 34 Rudolph WI 54475-9587
Phone: (715) 459-5255
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 1753-19 Wisconsin

Profile Details

NPI number 1164790366
LBN Legal business name Benjamin, Bethany Lynn
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2011
Last updated Oct 8th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164790366 NPPES
Wisconsin MEDICAID 1164790366

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