Provider Demographics
NPI:1396739645
Name:WAPLES, BENJAMIN J (ATC)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:J
Last Name:WAPLES
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 ADAMS AVE
Mailing Address - Street 2:APARTMENT 2D
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6635
Mailing Address - Country:US
Mailing Address - Phone:215-801-8730
Mailing Address - Fax:
Practice Address - Street 1:1101 CAMDEN AVE
Practice Address - Street 2:SALISBURY UNIVERSITY
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-6837
Practice Address - Country:US
Practice Address - Phone:215-801-8730
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0037522255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer