Provider Demographics
NPI:1235578949
Name:STRICKLAND, BENJAMIN ALLEN (RPT)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ALLEN
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 N WITHLACOOCHEE AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-2138
Mailing Address - Country:US
Mailing Address - Phone:843-621-4526
Mailing Address - Fax:
Practice Address - Street 1:300 S DARGAN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2537
Practice Address - Country:US
Practice Address - Phone:843-777-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist