Individual
MR. BENJAMIN W PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 N JOHN R WOODEN DR, WEST LAFAYETTE, IN 47907-2117
(765) 494-3248
Mailing address
2408 KESTRAL BLVD APT D, WEST LAFAYETTE, IN 47906-6526
17654300613
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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