Individual
KAREN A BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10170 ILLINOIS RD, FORT WAYNE, IN 46804-5774
(260) 436-6021
Mailing address
10170 ILLINOIS RD, FORT WAYNE, IN 46804-5774
(260) 436-6021
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027992A
IN
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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