Individual
SHANNON BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
630 NW ROSACEAE DR, BLUE SPRINGS, MO 64015-3679
(913) 671-0911
Mailing address
630 NW ROSACEAE DR, BLUE SPRINGS, MO 64015-3679
(913) 671-0911
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2014002066
MO
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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