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Individual

BRENT BENSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
25 MICHIGAN ST NE, SUITE 6100, GRAND RAPIDS, MI 49503-2515
(616) 267-7900
Mailing address
100 MICHIGN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006815
MI

Other

Enumeration date
01/08/2014
Last updated
01/08/2014
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