Individual
BENJAMIN GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13039 FALCON HIGHWAY, PEYTON, CO 80831-8024
(719) 209-3365
Mailing address
13039 FALCON HIGHWAY, PEYTON, CO 80831-8024
(719) 209-3365
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2099
CO
Other
Enumeration date
11/23/2015
Last updated
05/12/2021
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