Individual
MR. BENJAMIN BRANDT TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
305 N WASHINGTON AVE, IOLA, KS 66749-2350
(620) 431-0887
(620) 431-0887
Mailing address
PO BOX 623, CHANUTE, KS 66720-0623
(620) 431-0887
(620) 431-0816
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1102895
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102895
KS STATE LICENSE
KS
01
—
381860
FIRSTGUARD
—
Enumeration date
08/24/2005
Last updated
07/08/2007
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