Individual
PHILLIP PATRICK BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1070 SPILLWAY CIR, BRANDON, MS 39047-6035
(601) 829-0743
Mailing address
1070 SPILLWAY CIR, BRANDON, MS 39047-6035
(601) 829-0743
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-100714
MS
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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