Individual
BRANDI WATTS BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA-C
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1062
Mailing address
134 NORTHGATE RD, MYRTLE BEACH, SC 29572-5618
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
005698
GA
Other
Enumeration date
09/29/2009
Last updated
12/23/2010
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