Individual
STACEY RHODES BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
795 WILSON ST, WETUMPKA, AL 36092-2901
(334) 514-7135
Mailing address
795 WILSON ST, WETUMPKA, AL 36092-2901
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15037
AL
Other
Enumeration date
06/13/2013
Last updated
06/13/2013
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