Individual
MR. BENJAMIN A QUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT CSCS
Contact information
Practice address
2020 CHEYENNE CT, GRAFTON, WI 53024-0368
(262) 375-1075
(262) 375-4975
Mailing address
8914 W BONNIWELL, MEQUON, WI 53097
(414) 322-5750
(262) 241-5229
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9499024
WI
Other
Enumeration date
12/04/2006
Last updated
01/30/2008
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