Individual
BENJAMIN TAILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
92 WEST AVE, BROCKPORT, NY 14420-1306
(585) 637-0790
(585) 637-3572
Mailing address
92 WEST AVE, BROCKPORT, NY 14420-1306
(585) 637-0790
(585) 637-3572
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT301094
CA
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
11/28/2023
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