Provider Demographics
NPI:1629879820
Name:WESTRICH, BENNETT (DPT)
Entity type:Individual
Prefix:
First Name:BENNETT
Middle Name:
Last Name:WESTRICH
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 1:1652 ABBEY RD
Mailing Address - Street 2:
Mailing Address - City:BURTRUM
Mailing Address - State:MN
Mailing Address - Zip Code:56318-1049
Mailing Address - Country:US
Mailing Address - Phone:320-232-3442
Mailing Address - Fax:
Practice Address - Street 1:50 CENTRACARE DR
Practice Address - Street 2:
Practice Address - City:LONG PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56347-2100
Practice Address - Country:US
Practice Address - Phone:320-732-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist