Most Relevant Information
Provider Data
| NPI Number: | 1003203373 |
| Provider Name: | BENJAMIN SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/23/2015 |
| Last Updated: | 04/29/2022 |
Provider Practice Location
1025 PENNOCK PL
FORT COLLINS
CO
805243257
Practice Location Phone/Fax
| Phone: | 9704958800 |
| Fax: |
Provider Mailing Location
1025 PENNOCK PL
FORT COLLINS
CO
805243257
Provider Mailing Phone/Fax
| Phone: | 9704958800 |
| Fax: |