Individual
BENJAMIN MISEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST
Contact information
Practice address
1600 PINEBROOK BLVD APT C3, PARK CITY, UT 84098-8279
(860) 299-5477
Mailing address
1600 PINEBROOK BLVD APT C3, PARK CITY, UT 84098-8279
(860) 299-5477
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9783091-4701
UT
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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