Individual
MR. KENT STEPHEN KENNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1606 NORTH AVE, SAFEWAY PHARMACY, SPEARFISH, SD 57783
(605) 342-3909
Mailing address
PO BOX 416, BELLE FOURCHE, SD 57717-0416
(605) 569-1310
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
R5365
SD
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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