JEREMY BENACKA — OIG Excluded Provider (MAPLE GROVE, MN, 1128a1)
JEREMY BENACKA — OIG Excluded Provider (MAPLE GROVE, MN, 1128a1) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: JEREMY BENACKA; Type: Individual; Provider category: IND- LIC HC SERV PRO.
| Name | JEREMY BENACKA |
|---|---|
| Type | Individual |
| Provider category | IND- LIC HC SERV PRO |
| Specialty | PHYSICAL THERAPY |
| NPI | 1174001010 |
| City | MAPLE GROVE |
| State | MN |
| ZIP | 55311 |
| Exclusion authority | 1128a1 |
| Exclusion reason | Conviction of program-related crimes |
| Exclusion date | 2022-09-20 |
| Source | HHS-OIG LEIE |
$1499/mo
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