Individual
CALEB R BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4046 E CHURCH ST, FARMVILLE, NC 27828-1692
(252) 214-3356
Mailing address
4046 E CHURCH ST, FARMVILLE, NC 27828-1692
(252) 214-3356
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
37670725
NC
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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