Individual
KIMBER BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1125 N PINE ST, DERIDDER, LA 70634-2819
(337) 462-5794
Mailing address
1125 N PINE ST, DERIDDER, LA 70634-2819
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018912
LA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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