Individual
JUDITH BENESCH-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 W HART RD, BELOIT, WI 53511-2230
(608) 365-7500
Mailing address
1949 LAKE TRL, DELAVAN, WI 53115-3987
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1328019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36121100
—
WI
Enumeration date
05/04/2007
Last updated
07/08/2007
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