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Individual

BENJAMIN C SUDKAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MOT

Contact information

Practice address
913 BOLGER CT, FENTON, MO 63026-2030
(636) 305-9599
(636) 305-9799
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6250
(630) 575-7450

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
MO

Other

Enumeration date
02/25/2022
Last updated
02/25/2022
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