Individual
BENSON MIUGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 EDEN DR, LONGVIEW, TX 75605-4102
(903) 238-8085
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106268
TX
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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