Doctor Name: | MR. MOSES P. BENNY |
NPI Number: | 1144362682 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 5501006564 |
Business Practice Address: | 30671 Dequindre Rd Madison Heights, MI - 480712285 |
Business Phone Number: | 2485771340 |
Business Fax Number: | 2485771344 |
Mailing Address: | 30671 Dequindre Rd, MADISON HEIGHTS |
State: | MI |
Postal Code: | 480712285 |
Phone Number: | 2485771340 |
Fax Number: | 2485771344 |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501006564 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |