Individual
EDWARD BENKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2929 ROSS DR, S73, FORT COLLINS, CO 80526-6639
(970) 624-9019
Mailing address
PO BOX 1411, LAPORTE, CO 80535-1411
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
09/25/2014
Last updated
09/25/2014
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