Individual
BENJAMIN FREDERICK STAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
900 W 94TH ST, BLOOMINGTON, MN 55420-4206
(651) 738-9888
Mailing address
900 W 94TH ST, BLOOMINGTON, MN 55420-4206
(651) 738-9888
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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