Individual
GWIN BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7540 N 19TH AVE STE 200, PHOENIX, AZ 85021-7967
(970) 426-9181
Mailing address
450 PROSPECTOR AVE, DURANGO, CO 81301
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0012292
CO
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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