Braden Benson, DPT
Individual provider Active NPI Physical Therapist · Gillette, WY
NPI 1306338074 · NPPES record last updated May 30, 2018
Key facts
- NPI
- 1306338074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 1013 E Boxelder Rd
Gillette, WY 82718-5536 - Phone
- (307) 682-4900
- NPI assigned
- May 30, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2364 | SD | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
1013 E Boxelder Rd
Gillette, WY 82718-5536
Mailing address
PO Box 7132
Gillette, WY 82717-7132
Phone (307) 682-4900
Other providers in Gillette, WY
- Jacob Eugene Belyeu I
- Ben Lawrence Bennett
- Heather Nicole Bennett
- Kari Ann Bennett
- Stephanie Ann Bennington
- Stephanie Berens
- Edward Patrick Bergin
- Amanda Louise Bialas
- Kim Biegler
- Big Horn Pediatrics
All providers in Gillette, WY · Physical Therapist in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.