Individual
BENJAMIN R EGGLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1736 GEZON PKWY SW STE 100, WYOMING, MI 49519-9525
(616) 249-0750
Mailing address
5060 CASCADE RD SE STE A, GRAND RAPIDS, MI 49546-3808
(616) 249-0750
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501019460
MI
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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