Individual
BENJAMIN JOHN NEBELSICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
789 HOLTON DR, LE MARS, IA 51031-3757
(712) 546-1718
(712) 546-1770
Mailing address
PO BOX 921, LE MARS, IA 51031-0921
(712) 546-1718
(712) 546-1770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004987
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004987
STATE LICENSE NUMBER
IA
Enumeration date
07/11/2012
Last updated
07/11/2012
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