Provider Demographics
NPI:1710402953
Name:MAURER, BENJAMIN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:MAURER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 JOHNSON RD STE 303
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-8936
Mailing Address - Country:US
Mailing Address - Phone:724-223-2061
Mailing Address - Fax:724-223-2064
Practice Address - Street 1:8950 DR MARTIN LUTHER KING JR ST N STE 101
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-3001
Practice Address - Country:US
Practice Address - Phone:727-520-0800
Practice Address - Fax:727-520-0313
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist