Individual
BROCK BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
447 N 300 W, SUITE #5, KAYSVILLE, UT 84037-4203
(801) 544-2355
(801) 544-2358
Mailing address
447 N 300 W, SUITE #5, KAYSVILLE, UT 84037-4203
(801) 544-2355
(801) 544-2358
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
5493087-1202
UT
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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