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Individual

BENJAMIN FERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
4005 WESTMARK DR, SUITE 320, DUBUQUE, IA 52002-2271
(563) 588-3891
(563) 588-3893
Mailing address
4005 WESTMARK DR, SUITE 320, DUBUQUE, IA 52002-2271
(563) 588-3891
(563) 588-3893

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03661

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0665463
IA
Enumeration date
02/28/2007
Last updated
09/16/2011
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