Provider Demographics
NPI:1508833526
Name:BRAMWELL, BENTON MARK (ND)
Entity Type:Individual
Prefix:DR
First Name:BENTON
Middle Name:MARK
Last Name:BRAMWELL
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1496 E 5600 S
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4565
Mailing Address - Country:US
Mailing Address - Phone:801-475-6336
Mailing Address - Fax:801-475-7337
Practice Address - Street 1:1496 E 5600 S
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4565
Practice Address - Country:US
Practice Address - Phone:801-475-6336
Practice Address - Fax:801-475-7337
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2938421203175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath