Individual
BENJAMIN WILLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
600 CENTRAL AVE SE, SUITE D, ALBUQUERQUE, NM 87102-3656
(505) 242-2294
(505) 242-2917
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Enumeration date
03/15/2016
Last updated
01/12/2017
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