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Individual

LEWIS CALVIN BENTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
1430 VOLUNTEER PKWY, BRISTOL, TN 37620
(423) 968-2222
(423) 968-2348
Mailing address
143 HARR TOWN RD, BLOUNTVILLE, TN 37617-3829
(423) 323-1988
(423) 323-1988

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6433
TN

Other

Enumeration date
06/25/2007
Last updated
09/19/2008
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