Individual
BENJAMIN IWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
31 PALLADIUM LN, LADERA RANCH, CA 92694-1201
(612) 384-5889
Mailing address
31 PALLADIUM LN, LADERA RANCH, CA 92694-1201
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
91250
CA
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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