Individual
BENJAMIN WOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1105 MOUNT BATTEN DR, HANAHAN, SC 29410-3112
(803) 360-5007
Mailing address
1105 MOUNT BATTEN DR, HANAHAN, SC 29410-3112
(803) 360-5007
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2306604625
VA
225200000X
Physical Therapy Assistant
Primary
2583
SC
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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