Provider Demographics
NPI:1275766081
Name:BENEDICT, JANET WINGARD (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:WINGARD
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BRICKSTONE SQ
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1437
Mailing Address - Country:US
Mailing Address - Phone:610-925-4584
Mailing Address - Fax:
Practice Address - Street 1:515 BENTON ST
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-6883
Practice Address - Country:US
Practice Address - Phone:864-888-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC746225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist