Brenna, Benjamin John

Brenna, Benjamin John is an individual health care provider with primary practice located at 205 Oak St , Turtle Lake WI 54889-8929. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Brenna, Benjamin John can be contacted via phone (715) 986-2022.

Contact Information

Primary practice address
205 Oak St Turtle Lake WI 54889-8929
Phone: (715) 986-2022
Fax: (715) 986-2236
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 5791-024 Wisconsin

Profile Details

NPI number 1063471498
LBN Legal business name Brenna, Benjamin John
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jul 9th, 2012 - about 13 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 1063471498 NPPES
Wisconsin MEDICAID 84587-0007
Wisconsin Other 40314000

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