Individual
BENJAMEN WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
422 PECAN AVE, PORTAGE, MI 49024-2744
(616) 737-1750
Mailing address
422 PECAN AVE, PORTAGE, MI 49024-2744
(616) 737-1750
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501004580
MI
Other
Enumeration date
09/01/2023
Last updated
09/01/2023
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