Individual
MR. GORDON BENNETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 CRYSTAL AVE, DERRY, NH 03038-2412
(603) 437-9799
Mailing address
54 LAWRENCE RD, DERRY, NH 03038-4191
(603) 432-5109
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1850
NH
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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