Individual
BENJAMIN LIPPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
533 W COLUMBIA ST, EVANSVILLE, IN 47710-1617
(812) 759-3001
(812) 401-9013
Mailing address
7300 E INDIANA ST, STE. 102, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
005391
KY
225100000X
Physical Therapist
Primary
05005650A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000280217
BLUE CROSS BLUE SHIELD
IN
05
—
200818630
—
IN
01
—
P00060081
MEDICARE RAILROAD
IN
Enumeration date
12/05/2005
Last updated
03/16/2009
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