Individual
DJAMIL CLARK BENCHOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
701 LANSDALE AVE, LANSDALE, PA 19446-2958
(215) 368-0900
Mailing address
24 E 3RD ST, LANSDALE, PA 19446-2649
(267) 261-0691
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP007472
PA
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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