Individual
ROBERT L BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5119 GATEWAY ST SE UNIT 304, PRIOR LAKE, MN 55372-5537
(612) 638-8311
(612) 638-8311
Mailing address
5119 GATEWAY ST SE UNIT 304, PRIOR LAKE, MN 55372-2167
(612) 638-8311
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
PCA55519820160831
MN
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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