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1295935666
BENJAMIN J MICKENS
SAN ANTONIO, TX
NPI
1295935666
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
Enumeration Date
2007-07-23
Last Update Date
2007-07-23
Business Address
-- BENJAMIN J MICKENS
7330 SAN PEDRO SUITE 130
SAN ANTONIO, TX 78216-6235
Phone number: 210-349-0550
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Mailing Address
-- BENJAMIN J MICKENS
8311 COPPERSIDE
CONVERSE, TX 78109-3901
Phone number: 210-724-0968
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