Provider Demographics
NPI:1093745325
Name:MEDLIN, BENJAMIN CRAIG (MA, LAT, ATC, EMT)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:CRAIG
Last Name:MEDLIN
Suffix:
Gender:M
Credentials:MA, LAT, ATC, EMT
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Mailing Address - Street 1:1920 MCGUINN DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3332
Mailing Address - Country:US
Mailing Address - Phone:336-819-2800
Mailing Address - Fax:336-887-5585
Practice Address - Street 1:1920 MCGUINN DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3332
Practice Address - Country:US
Practice Address - Phone:336-819-2800
Practice Address - Fax:336-887-5585
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer