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Individual

BENJAMIN CLARK HERMANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RD

Contact information

Practice address
1739 W SUNSET BLVD, ST GEORGE, UT 84770-7141
(435) 634-6000
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 634-6000

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
10389003-4901
UT
133V00000X
Registered Dietitian

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86076257
COMISSION ON DIETETIC REGISTRATION
Enumeration date
05/18/2017
Last updated
07/20/2023
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