Individual provider · Type 1 NPI

Jerrad Lee Benton, LMT, MMP

Massage Therapist · St. Louis, MO

NPI number 1891211017 Active

Practice location

2430 Tellicherry Dr
St. Louis, MO 63125-3108

Call (314) 600-6293 Map

Mailing address

2430 Tellicherry Dr., 300A
St. Louis, MO 63125-3108

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X2001031193 (MO)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1891211017

Jerrad Lee Benton, LMT, MMP's National Provider Identifier is 1891211017, issued on Aug 18, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in St. Louis, MO. The record was last updated on Jul 21, 2022.