Individual
MR. BENJAMIN JOHN WALLIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
39885 GRAND RIVER, STE 300, NOVI, MI 48375
(248) 615-0282
(248) 615-0415
Mailing address
39885 GRAND RIVER, STE 300, NOVI, MI 48375
(248) 615-0282
(248) 615-0415
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1585173
MI
Other
Enumeration date
03/29/2006
Last updated
07/08/2007
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