Provider Demographics
NPI:1366579476
Name:BENEDICT, CORI ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:CORI
Middle Name:ANN
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 WESTMOOR RD
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-2850
Mailing Address - Country:US
Mailing Address - Phone:419-306-6147
Mailing Address - Fax:
Practice Address - Street 1:1725 WESTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1345
Practice Address - Country:US
Practice Address - Phone:419-422-5526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011674225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2495590Medicaid
OH2251343Medicaid
OH366639Medicare ID - Type Unspecified
OH9313985Medicare PIN
OH2495590Medicaid
OH2251343Medicaid