Individual
BENJAMIN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4922 YELLOWSTONE AVE STE J, CHUBBUCK, ID 83202-2360
(208) 237-1882
(208) 904-2990
Mailing address
4922 YELLOWSTONE AVE STE J, CHUBBUCK, ID 83202-2360
(208) 237-1882
(208) 904-2990
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-9030
ID
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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