Individual
MR. MICHAEL DAVID BENAVIDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T., M.M.P.
Contact information
Practice address
1204 LANDAU LN, MOUNT PLEASANT, SC 29466-7301
(817) 602-7922
Mailing address
1204 LANDAU LN, MOUNT PLEASANT, SC 29466-7301
(817) 602-7922
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS.8495R
SC
225700000X
Massage Therapist
MT109593
TX
Other
Enumeration date
07/06/2013
Last updated
07/06/2013
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