Individual
BRIAN BENTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1807 E QUEEN CREEK RD STE 7, CHANDLER, AZ 85286-2023
(480) 361-4604
(480) 237-9474
Mailing address
1951 E ASTER PL, CHANDLER, AZ 85286-2505
(602) 793-2095
(480) 237-9474
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6089
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118519
MEDICARE PTAN
AZ
Enumeration date
07/30/2006
Last updated
04/28/2022
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