Provider Demographics
NPI:1912145939
Name:SIGERS, BENJAMIN DANIEL (ATC)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:DANIEL
Last Name:SIGERS
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 1:331 CAMPUS LN
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-4655
Mailing Address - Country:US
Mailing Address - Phone:770-856-2103
Mailing Address - Fax:
Practice Address - Street 1:331 CAMPUS LN
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-4655
Practice Address - Country:US
Practice Address - Phone:770-856-2103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL25382255A2300X
GAAT0018042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer