Individual
BRET BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
335 N FAIRGROUNDS RD, PRICE, UT 84501-4208
(435) 650-4105
Mailing address
13019 ELM JCT UNIT 101, SAN ANTONIO, TX 78249-4901
(435) 650-4105
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
14219291-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/04/2024
Last updated
07/02/2025
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