Individual
KATHERINE ELIZABETH BENTON-BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2001021506
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346653672
NPI UNDER ABILITY NETWORK ORGANIZATION
—
Enumeration date
05/22/2015
Last updated
05/22/2015
Update your record
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