Individual
NICHOLAS EDMOND BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
8325 W INDIAN SCHOOL RD, PHOENIX, AZ 85037-2125
(623) 245-7353
(623) 245-7347
Mailing address
2522 N RILEY RD, BUCKEYE, AZ 85396-1549
(623) 570-1947
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S018497
AZ
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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