Individual
KRISTINA BENEDICT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15761 GOLFVIEW DR, RIVERVIEW, MI 48193-8090
(313) 492-4161
Mailing address
15761 GOLFVIEW DR, RIVERVIEW, MI 48193-8090
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
821433533
MI
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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