Individual
BENJI MARIE BASARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7740C STENTON AVE, APT 111, PHILADELPHIA, PA 19118-3170
(917) 582-5467
Mailing address
7740C STENTON AVE, APT 111, PHILADELPHIA, PA 19118-3170
(917) 582-5467
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017876
PA
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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