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Individual

MR. BENJAMIN CHUKWUMA IGWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
23000 MOAKLEY ST, SUITE 101, LEONARDTOWN, MD 20650-2915
(301) 475-6507
(301) 475-6507
Mailing address
23000 MOAKLEY ST, SUITE 101, LEONARDTOWN, MD 20650-2915
(301) 475-6507
(301) 475-6507

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
029621-1
NY
2251X0800X
Orthopedic Physical Therapist
Primary
22381
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029621-1
PT LICENSE
NY
01
22381
PT LICENSE
MD
Enumeration date
10/19/2009
Last updated
10/19/2009
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