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Organization
PROACTIVE PHYSICAL THERAPY AND EXERCISE CENTER, INC
Active
Organization
PROACTIVE PHYSICAL THERAPY AND EXERCISE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN W BENJAMIN DPT (PRESIDENT)
(970) 224-4141
Entity
Organization
Contact information
Practice address
1024 CENTRE AVE STE 100, FORT COLLINS, CO 80526-1887
(970) 224-4141
Mailing address
2108 MIDPOINT DR, FORT COLLINS, CO 80525-4323
(970) 224-4141
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7782
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7782
STATE LICENSE
CO
Enumeration date
11/30/2007
Last updated
03/22/2018
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