Organization
WONDERFULLY MADE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BENSINGER (OWNER/PHYSICAL THERAPIST)
(314) 440-6240
Entity
Organization
Contact information
Practice address
1215 DORNEWOOD PL, BALLWIN, MO 63021-6879
(314) 440-6240
Mailing address
1215 DORNEWOOD PL, BALLWIN, MO 63021-6879
(314) 440-6240
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2003006580
MO
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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