Individual
PHILLIP M. BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1221
(801) 587-4281
Mailing address
500 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1221
(801) 587-4281
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12404256-1204
UT
Other
Enumeration date
03/25/2020
Last updated
09/10/2021
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