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Individual

MR. ROBERT J BENSON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, OCS

Contact information

Practice address
4605 MACCORKLE AVENUE SW, SOUTH CHARLESTON, WV 25309
(304) 766-3589
(304) 766-3793
Mailing address
37 MILL CREEK XING, HURRICANE, WV 25526-8701
(304) 389-9283

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
WV002427
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1714911
BLUE CROSS BLUE SHIELD
WV
01
31150445300
WORKERS COMP
WV
05
3810000-760
WV
01
7808579
AETNA
WV
Enumeration date
12/15/2006
Last updated
02/05/2008
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