Individual
ADAM BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2425 13TH AVE S, FARGO, ND 58103-3749
(701) 232-4872
Mailing address
2425 13TH AVE S, FARGO, ND 58103-3749
(701) 232-4872
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
119207
MN
183500000X
Pharmacist
Primary
RPH5115
ND
Other
Enumeration date
02/04/2017
Last updated
02/04/2017
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