Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 1248672 | TX |
NPI | 1003368820 |
---|---|
Provider Name | Benjamin Volkman |
First Address | Richmond, TX 77469-1883 |
Second Address | Dallas, TX 75231-4313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2016 |
Last Update Date | 04/06/2020 |