Individual
MR. BENJAMIN L WIDDER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4 FORGE RD, BOILING SPRINGS, PA 17007-9444
(717) 258-6484
Mailing address
293 KAUFFMAN RD E, CHAMBERSBURG, PA 17201-9247
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000941A
PA
Other
Enumeration date
02/13/2006
Last updated
07/08/2007
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