Individual
BENJAMIN KUSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1002 DIAMOND RDG, JEFFERSON CITY, MO 65109-6896
(573) 761-9360
Mailing address
302 RIDGEWAY DR, JEFFERSON CITY, MO 65109-0786
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
2002022537
MO
Other
Enumeration date
06/01/2015
Last updated
06/01/2015
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