Doctor Name: | BENJAMIN WICKI |
NPI Number: | 1053717124 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 10204 |
Business Practice Address: | 30 Church Hill Rd Newtown, CT - 064701658 |
Business Phone Number: | 2034268449 |
Business Fax Number: | 2034268980 |
Mailing Address: | 30 Church Hill Rd, NEWTOWN |
State: | CT |
Postal Code: | 064701658 |
Phone Number: | 2034268449 |
Fax Number: | 2034268980 |
NPI Enumeration Date: | 11/17/2014 |
NPI Last Update Date: | 11/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 10204 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |