JEREMY BENACKA
Individual Provider (NPI-1)
Active
Physical Therapist
Provider Information
- NPI Number
1174001010- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 16720 73RD PL N, MAPLE GROVE, MN, 553112130
- Phone
- (612) 685-2919
Specialties & Taxonomies
Physical Therapist
Primary License: MN #5489
All Addresses
MAILING
16720 73RD PL N
MAPLE GROVE, MN, 553112130