Individual
MS. MAE MILDRED BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
2705 D INDUSTRIAL DRIVE, JEFFERSON CITY, MO 65109
(573) 635-5911
Mailing address
2705 D INDUSTRIAL DRIVE, JEFFERSON CITY, MO 65109
(573) 635-5911
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2001014178
MO
Other
Enumeration date
09/13/2007
Last updated
09/13/2007
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