Individual
BENEDICT JOHN STOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
901 RIDGE RD, ROXBORO, NC 27573-4511
(336) 599-4030
Mailing address
4404 COOPER RD, WINSTON SALEM, NC 27127-8781
(518) 269-5623
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5193
NC
Other
Enumeration date
08/09/2013
Last updated
08/09/2013
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