Individual
BRANDON ALLEN KENWORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 S VINE ST, ARTHUR, IL 61911-1334
(217) 543-2913
Mailing address
118 S VINE ST, ARTHUR, IL 61911-1334
(217) 543-2913
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051291918
IL
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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