Individual
COURTNEY BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4339 EBENEZER RD, BALTIMORE, MD 21236-2143
(410) 529-6171
Mailing address
5909 WESTERN RUN DR APT B, BALTIMORE, MD 21209-4037
(202) 352-2689
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
25506
MD
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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