Individual
MR. ANACLETO R BENITO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-7140
Mailing address
817 SOEST RD, ROLLA, MO 65401-3447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT106572
MO
Other
Enumeration date
07/04/2007
Last updated
07/08/2007
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