Individual
KELLY BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1191 DIXWELL AVE, HAMDEN, CT 06514-4733
(203) 230-2803
Mailing address
1191 DIXWELL AVE, HAMDEN, CT 06514-4733
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0011442
CT
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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