BRENT D HERRON

CHAMPAIGN, IL
NPI1427659820
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: IL  051302607)
Additional Taxonomies183500000X Pharmacist
(Licence: IN  26023781a)
Enumeration Date2020-11-03
Last Update Date2020-11-03
Business Address
BRENT D HERRON
2610 N PROSPECT AVE
CHAMPAIGN, IL 61822-1251
Phone number: 217-352-1490
Mailing Address
BRENT D HERRON
2610 N PROSPECT AVE
CHAMPAIGN, IL 61822-1251
Phone number: 217-352-1490