Individual
KEITH ROBERT BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
5353 YELLOWSTONE RD RM 211, CHEYENNE, WY 82009-4178
(888) 385-0235
Mailing address
460 MANEWAL DR APT B, CHEYENNE, WY 82009-4083
(908) 202-7575
(908) 202-7575
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3983
WY
183500000X
Pharmacist
PHA.0021975
CO
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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