Provider Demographics
NPI:1053977355
Name:ENGLAND, BENJAMIN SCOTT (PT, DPT, CSCS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:SCOTT
Last Name:ENGLAND
Suffix:
Gender:M
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 BRECKENRIDGE PASS
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-8666
Mailing Address - Country:US
Mailing Address - Phone:740-403-9133
Mailing Address - Fax:
Practice Address - Street 1:12912 COLDWATER RD STE 9C
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-8870
Practice Address - Country:US
Practice Address - Phone:260-739-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05013330A2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN05013330AOtherPT LICENSE