Individual
MR. MICHAEL PAUL BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
612 N. PASEO DE PERALTA, ESPANOLA, NM 87532-2963
(505) 753-2203
Mailing address
PO BOX 2891, ESPANOLA, NM 87532-4891
(505) 920-0092
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0145591
NM
Other
Enumeration date
02/06/2012
Last updated
05/08/2013
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