Provider Demographics
NPI:1821496738
Name:WALKER, BENJAMIN (MSTOM)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:MSTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BANK ROW ST
Mailing Address - Street 2:2S
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-5300
Mailing Address - Country:US
Mailing Address - Phone:413-992-8877
Mailing Address - Fax:
Practice Address - Street 1:3 BANK ROW ST
Practice Address - Street 2:2S
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-5300
Practice Address - Country:US
Practice Address - Phone:413-992-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-09
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist