Provider Demographics
NPI:1124561634
Name:BIDDINGER, BENJAMIN (ATC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:BIDDINGER
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 1:82 SAMARITAN AVE APT A2
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3970
Mailing Address - Country:US
Mailing Address - Phone:614-595-6206
Mailing Address - Fax:
Practice Address - Street 1:82 SAMARITAN AVE APT A2
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3970
Practice Address - Country:US
Practice Address - Phone:614-595-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0058742255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer