Provider Demographics
NPI:1477755437
Name:BENEDICT, SUZANNE (PT)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:
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 1:6959 S CLERMONT ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2137
Mailing Address - Country:US
Mailing Address - Phone:720-596-4639
Mailing Address - Fax:
Practice Address - Street 1:6959 S CLERMONT ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2137
Practice Address - Country:US
Practice Address - Phone:720-596-4639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist