Provider Demographics
NPI:1467178335
Name:BENSON SPORTS THERAPY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:BENSON SPORTS THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:DANE
Authorized Official - Last Name:HEFNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:919-701-1251
Mailing Address - Street 1:300 E CHURCH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-1555
Mailing Address - Country:US
Mailing Address - Phone:919-701-1251
Mailing Address - Fax:919-701-1261
Practice Address - Street 1:300 E CHURCH ST STE 5
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-1555
Practice Address - Country:US
Practice Address - Phone:919-701-1251
Practice Address - Fax:919-701-1261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy