Individual
ANDREW BENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
110 HORTON FIELD HOUSE, CAMPUS BOX 7130, NORMAL, IL 61790-7130
(217) 725-7525
Mailing address
110 HOTON FIELD HOUSE, CAMPUS BOX 7130, NORMAL, IL 61790-7130
(217) 725-7525
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003879
IL
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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