Individual
BENTON LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3098 G ST, MERCED, CA 95340-2137
(209) 385-3424
(209) 385-3630
Mailing address
3098 G ST, MERCED, CA 95340-2137
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
64711
CA
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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