Individual
BENJAMIN CORTEZ LAXAMANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
342 DALE CT, VACAVILLE, CA 95688-9472
(707) 685-6077
(707) 514-7178
Mailing address
342 DALE CT, VACAVILLE, CA 95688-9472
(707) 685-6077
(707) 514-7178
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
28375
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28375
PHYSICAL THERAPY BOARD OF CALIFORNIA
CA
Enumeration date
06/11/2008
Last updated
01/14/2017
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