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1164930558
ROBERT L BENTON
PRIOR LAKE, MN
NPI
1164930558
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
374U00000X Home Health Aide
(Licence: MN pca55519820160831)
Enumeration Date
2018-01-19
Last Update Date
2018-01-19
Business Address
ROBERT L BENTON
5119 GATEWAY ST SE UNIT 304
PRIOR LAKE, MN 55372-5537
Phone number: 612-638-8311
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Mailing Address
ROBERT L BENTON
5119 GATEWAY ST SE UNIT 304
PRIOR LAKE, MN 55372-2167
Phone number: 612-638-8311
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