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Individual

MR. ROBERT FRED BENNECKE JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
KT

Contact information

Practice address
1501 SAN PEDRO SE, ALBUQUERQUE, NM 87108
(505) 265-1711
(505) 256-5704
Mailing address
PO BOX 627, SANDIA PARK, NM 87047
(505) 286-0169
(505) 256-5704

Taxonomy

Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary

Other

Enumeration date
05/17/2006
Last updated
07/08/2007
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