Provider Demographics
NPI:1003329145
Name:KASPER, BEN CHRISTIAN (ATC)
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:CHRISTIAN
Last Name:KASPER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-6705
Mailing Address - Country:US
Mailing Address - Phone:651-285-7105
Mailing Address - Fax:
Practice Address - Street 1:1018 N 20TH ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-6705
Practice Address - Country:US
Practice Address - Phone:651-285-7105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer