| Doctor Name: | MR. BENJAMIN NATHANIEL SHATTO |
| NPI Number: | 1609960947 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPT |
| License Number: | PT-1883 |
| Business Practice Address: | 1456 E Iron Eagle Dr Eagle, ID - 836166598 |
| Business Phone Number: | 2089399895 |
| Business Fax Number: | 8316366108 |
| Mailing Address: | Po Box 2422, HOLLISTER |
| State: | CA |
| Postal Code: | 950242422 |
| Phone Number: | 8316366108 |
| Fax Number: | 8316366108 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 08/07/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT-1883 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| 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 |