Individual
KENNELL BENITEZ-DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
111 N WALL ST UNIT 1334, BELTON, TX 76513-0130
(512) 769-8441
Mailing address
111 N WALL ST UNIT 1334, BELTON, TX 76513-0130
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT137551
TX
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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