Individual
JANET BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
919 W MERCURY BLVD, HAMPTON, VA 23666-4322
(757) 827-2995
Mailing address
465 COLONY RD, NEWPORT NEWS, VA 23602-6309
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202204476
VA
Other
Enumeration date
09/01/2011
Last updated
09/03/2011
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