Individual
MR. ROBERT J BENSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS
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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