Provider Demographics
NPI:1750945796
Name:SCHMITT, BENJAMIN THOMAS (DPT)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:THOMAS
Last Name:SCHMITT
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 1:300 SOUTH TWINING STREET
Mailing Address - Street 2:BLDG. 760, 42D MEDICAL GROUP
Mailing Address - City:MAXWELL AFB
Mailing Address - State:AL
Mailing Address - Zip Code:36112
Mailing Address - Country:US
Mailing Address - Phone:334-953-3368
Mailing Address - Fax:334-953-8607
Practice Address - Street 1:300 SOUTH TWINING STREET
Practice Address - Street 2:BLDG. 760, 42D MEDICAL GROUP
Practice Address - City:MAXWELL AFB
Practice Address - State:AL
Practice Address - Zip Code:36112
Practice Address - Country:US
Practice Address - Phone:334-953-3368
Practice Address - Fax:334-953-8607
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist