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Individual

BENTON COILEY STRAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
204 HIGHWAY 80 E, CLINTON, MS 39056-4716
(601) 926-1179
(601) 926-1234
Mailing address
107 ST REGIS DR, MADISON, MS 39110-7939
(601) 270-8536
(601) 926-1234

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-05971
MS

Other

Enumeration date
01/03/2012
Last updated
01/03/2012
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