Individual
LYDIA BENJAMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, ATC
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-2111
(215) 707-2324
Mailing address
417 W HORTTER ST, PHILADELPHIA, PA 19119-3646
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003676
PA
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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