Individual
BROOKE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1920 ELM ST, DUBUQUE, IA 52001-3641
(563) 583-7379
Mailing address
2821 JEFFERSON AVE, DAVENPORT, IA 52803-1605
(515) 368-0474
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23444
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23444
NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (NABP)
IA
Enumeration date
08/28/2018
Last updated
08/28/2018
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