JEFFREY RYAN BENNETT
Individual Provider (NPI-1)
Active
Pharmacy, Community/Retail Pharmacy
Provider Information
- NPI Number
1205642592- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 2005 S MARIPOSA RD, STOCKTON, CA, 95205
- Phone
- (209) 464-7722
- Fax
- (209) 464-3780
Specialties & Taxonomies
Pharmacy, Community/Retail Pharmacy
Primary License: CA #PHY59418