Individual
BENJAMIN JACOB ANDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
940 WOODLAND AVE, DULUTH, MN 55812-1113
(218) 723-6081
Mailing address
940 WOODLAND AVE, DULUTH, MN 55812-1113
(187) 236-0812
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A2555
MN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/09/2021
Last updated
09/14/2024
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