Benjamin Detzner

NPI #1922641422 in Wilmette, Illinois

Provider Information

NPI Number: 1922641422
Entity Type: Individual
Name: Benjamin Detzner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Oct 28, 2019
Last Updated: Oct 28, 2019

Practice Location

Address: 521 GREEN BAY RD
City: Wilmette
State: Illinois
ZIP Code: 60091-2726
Phone: (847) 724-4864

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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