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Individual

AMANDA D. BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM D.

Contact information

Practice address
204 S CRIM AVE, BELINGTON, WV 26250-9662
(304) 823-1001
Mailing address
440 S MAIN ST, PHILIPPI, WV 26416-0015
(304) 457-4233

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0006886
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RP0006886
WV BOARD OF PHARMACY
WV
Enumeration date
02/04/2013
Last updated
11/19/2020
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