Doctor Name: | MRS. HEATHER RAE BENNINGTON |
NPI Number: | 1336417484 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.T.C., P.T. |
License Number: | 6950 |
Business Practice Address: | 3838 12th Ave N Fargo, ND - 581022931 |
Business Phone Number: | 7012344703 |
Business Fax Number: | |
Mailing Address: | 3838 12th Ave N, FARGO |
State: | ND |
Postal Code: | 581022931 |
Phone Number: | 7012344703 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2011 |
NPI Last Update Date: | 12/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6950 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
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 |