Individual
MIRANDA KAY BENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, AT, ATC
Contact information
Practice address
1800 COLLEGE AVE, QUINCY, IL 62301-2670
(217) 228-5432
(217) 228-5604
Mailing address
606 N 5TH ST, CANTON, MO 63435-1100
(920) 639-9272
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004631
IL
Other
Enumeration date
08/11/2015
Last updated
12/15/2023
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