Individual
BENJAMIN GEORGE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1 COLOMBA DR STE 5, NIAGARA FALLS, NY 14305-1275
(716) 298-2249
Mailing address
2111 FIX RD, GRAND ISLAND, NY 14072-2547
(716) 864-7929
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
047686
NY
Other
Enumeration date
03/04/2022
Last updated
03/04/2022
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