Provider Demographics
NPI:1487427167
Name:TRAN, BENJAMIN TRI SI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:TRI SI
Last Name:TRAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 98TH CIR N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1867
Mailing Address - Country:US
Mailing Address - Phone:763-222-7024
Mailing Address - Fax:
Practice Address - Street 1:11855 ULYSSES ST NE STE 20
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3949
Practice Address - Country:US
Practice Address - Phone:763-767-3140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist