Individual
MATRICE BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 DALTON DR, VILLA RICA, GA 30180-7340
(770) 666-1779
Mailing address
112 DALTON DR, VILLA RICA, GA 30180-7340
(770) 666-1779
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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