Provider Information for 1528550258
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BENJAMIN CURTIS FANNIN DPT
Sex: Male
NPI: 1528550258
Last Updated: 2018-05-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1528550258 | ||||||||
| Enumeration Date | 2018-05-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 10400 READING RD STE 105 CINCINNATI, OH 45241-4839 United States Phone: 513-733-3370 | Fax:513-786-7893 | ||||||||
| Primary Practice Address | 10400 READING RD STE 105 CINCINNATI, OH 45241-4839 United States Phone: 513-733-3370 | Fax:513-786-7893 | ||||||||
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