Individual
DR. BRENT JUSTIN ICENHOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
317 N SALISBURY AVE, SPENCER, NC 28159-2513
(704) 633-1604
(704) 633-9660
Mailing address
317 N SALISBURY AVE, SPENCER, NC 28159-2513
(704) 633-1604
(704) 633-9660
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19068
NC
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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