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Individual
FRED BENSON
Active
Individual
FRED BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OWNER
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
27064077A
IN
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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