Provider Demographics
NPI:1710003116
Name:BENNER, VALERIE ANNE (PT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANNE
Last Name:BENNER
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 1:356 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-7136
Mailing Address - Country:US
Mailing Address - Phone:610-272-4889
Mailing Address - Fax:
Practice Address - Street 1:404 CHESWICK PL
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1251
Practice Address - Country:US
Practice Address - Phone:610-527-6500
Practice Address - Fax:610-520-1207
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-007372-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist