Individual
BRANDON BENOIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
999 SW DISK DR STE 105, BEND, OR 97702-3060
(541) 639-8911
Mailing address
61110 BROOKHOLLOW DR UNIT 2, BEND, OR 97702-2938
(603) 831-8127
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-21681
OR
Other
Enumeration date
07/06/2019
Last updated
07/06/2019
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