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General NPI Number Information
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NPI Number | 1780184069
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Entity Type | Individual
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Provider Name | BENJAMIN JOSEPH ONELOVE
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Gender | Male
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Dates
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Enumeration Date | 02/13/2018
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 1349 SYCAMORE ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-3005
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Country | US
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Telephone | 952-261-9244
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Fax | 715-814-9621
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Provider Business Mailing Address
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Address Line | 1349 SYCAMORE ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-3005
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Country | US
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Telephone | 952-261-9244
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Fax | 715-814-9621
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 13087-146
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License Number State | WI
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