Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BENJAMIN M WILLY, ATC
ActiveMR. BENJAMIN M WILLY, ATC is a Athletic Trainer healthcare provider located in JASPER, Tennessee. NPI 1164854303 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · JASPER, TN
Registration Details
- NPI Number
- 1164854303
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 30, 2013 (13.048414124476 yrs)
- Last Updated
- May 13, 2016
- Licenses
-
2056 (TN)AT 558 (AR)
Practice Information
- Address
-
4150 MAIN STJASPER, TN, 373473445Browse TN providers · Browse ZIP 37347
- Phone
- 4239428073
- Fax
- 4239426660
- Primary Specialty
-
Athletic Trainer
2255A2300X
- Additional Specialty
- Athletic Trainer
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.