Individual
MR. BRADDON CHARLES BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
9440 CITRUS AVE, FONTANA, CA 92335-5512
(909) 823-3481
Mailing address
9440 CITRUS AVE, FONTANA, CA 92335-5512
(909) 823-3481
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
19019
CA
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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