Individual
CHRISTOPHER WILLIAM BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
3631 PETERS CREEK RD NW, ROANOKE, VA 24019-2809
(540) 563-3500
Mailing address
3631 PETERS CREEK RD NW, ROANOKE, VA 24019-2809
(540) 563-3500
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202211596
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202211596
STATE PHARMACIST LICENSE
VA
Enumeration date
07/30/2012
Last updated
07/30/2012
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