BENJAMIN FONSECA

CHARLOTTE, NC
NPI1124459862
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NC  1814)
Enumeration Date2013-12-05
Last Update Date2013-12-05
Business Address
-- BENJAMIN FONSECA
10318 GLENBURN LN
CHARLOTTE, NC 28278-6005
Phone number: 704-906-8095
Mailing Address
-- BENJAMIN FONSECA
10318 GLENBURN LN
CHARLOTTE, NC 28278-6005
Phone number: 704-906-8095