Individual
MISS THERESA M BENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTECTOMY FITTER
Contact information
Practice address
1001 BALTIMORE PIKE, SUITE 205, SPRINGFIELD, PA 19064
(610) 604-0950
(610) 604-0970
Mailing address
1001 BALTIMORE PIKE, SUITE 205, SPRINGFIELD, PA 19064
(610) 604-0950
(610) 604-0970
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1435
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232916
BCBS
PA
Enumeration date
06/13/2007
Last updated
07/08/2007
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