Provider Demographics
NPI:1629214457
Name:HINCHCLIFF, BENJAMIN ROY (PT)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:ROY
Last Name:HINCHCLIFF
Suffix:
Gender:M
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:P.O. BOX 80572
Mailing Address - Street 2:OWEN PHYSICAL THERAPY
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48908-0572
Mailing Address - Country:US
Mailing Address - Phone:517-882-1192
Mailing Address - Fax:517-882-1193
Practice Address - Street 1:134 EAST EDGEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911
Practice Address - Country:US
Practice Address - Phone:517-882-1192
Practice Address - Fax:517-882-1193
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009176225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist