Provider Demographics
NPI:1184609299
Name:COLE, BENJAMIN T (DPT)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:T
Last Name:COLE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 AUTUMN HILL DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-4815
Mailing Address - Country:US
Mailing Address - Phone:724-554-5971
Mailing Address - Fax:
Practice Address - Street 1:7000 STONEWOOD DR
Practice Address - Street 2:SUITE 230
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7376
Practice Address - Country:US
Practice Address - Phone:724-933-0300
Practice Address - Fax:724-933-0456
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist