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MR. JERRAD LEE BENTON LMT, MMP
NPI 1891211017
Massage Therapist in Saint Louis, MO

Active since August 18, 2017
2430 TELLICHERRY DR, SAINT LOUIS, MO 63125(314) 600-6293 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 21, 2022, Aug 18, 2017 (2 updates tracked since 2017).

About Mr. Jerrad Lee Benton Lmt, Mmp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JERRAD LEE BENTON LMT, MMP (NPI 1891211017) is an individual massage therapist in Saint Louis, Missouri, licensed in Missouri (2001031193) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1891211017
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameMR. JERRAD LEE BENTONCredential: LMT, MMP
Location Address2430 TELLICHERRY DRSaint Louis, MO 63125-3108
Mailing Address2430 Tellicherry Dr., 300aSaint Louis, MO 63125-3108 · (314) 600-6293
Phone(314) 600-6293
Sole ProprietorYes
Enumeration DateAugust 18, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1891211017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in MO · 2001031193
Definition

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.

2430 TELLICHERRY DR, Saint Louis, MO 63125
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Reviews for MR. JERRAD LEE BENTON LMT, MMP

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Frequently Asked Questions

What is Jerrad Benton's NPI number?

The NPI number assigned to this healthcare provider is 1891211017, enumerated as an "individual" on August 18, 2017.

Where is the provider located?

The provider is located at 2430 TELLICHERRY DR SAINT LOUIS, MO 63125 and the phone number is (314) 600-6293.

What is the provider's specialty?

Massage Therapist with taxonomy code 225700000X.