Individual
BENJAMIN D FIGHTMASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1306 GEMINI CIR STE 2, OTTAWA, IL 61350-1695
(085) 081-5433
Mailing address
1306 GEMINI CIR STE 2, OTTAWA, IL 61350-1695
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008585
IL
Other
Enumeration date
04/26/2020
Last updated
04/26/2020
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