Provider Demographics
NPI:1174792055
Name:BENDER, MICHAEL ANDREW (DPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANDREW
Last Name:BENDER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 WINEBERRY CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-9207
Mailing Address - Country:US
Mailing Address - Phone:717-725-4764
Mailing Address - Fax:
Practice Address - Street 1:600 SHREWSBURY COMMONS AVE STE 9A
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1616
Practice Address - Country:US
Practice Address - Phone:717-227-2230
Practice Address - Fax:717-227-0509
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017755225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist