Individual
MS. CAROL BENJAMIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
6640 GUNPARK DR STE 102, BOULDER, CO 80301-7001
(303) 938-3770
(720) 542-8932
Mailing address
2119 WESTLAKE DR, LONGMONT, CO 80503-8102
(303) 684-9456
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3878
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3878
P T LICENSE
CO
Enumeration date
08/31/2006
Last updated
12/05/2011
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