Provider Demographics
NPI:1457918914
Name:FRANK, BENJAMIN (PTA)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:FRANK
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10620 S HIGHWAY 259
Mailing Address - Street 2:
Mailing Address - City:MC DANIELS
Mailing Address - State:KY
Mailing Address - Zip Code:40152-7236
Mailing Address - Country:US
Mailing Address - Phone:270-617-3553
Mailing Address - Fax:
Practice Address - Street 1:10620 S HIGHWAY 259
Practice Address - Street 2:
Practice Address - City:MC DANIELS
Practice Address - State:KY
Practice Address - Zip Code:40152-7236
Practice Address - Country:US
Practice Address - Phone:270-617-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA03857225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant