Provider Demographics
NPI:1609503481
Name:BENSON, BRYTON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRYTON
Middle Name:
Last Name:BENSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1189 E 700 S
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4022
Mailing Address - Country:US
Mailing Address - Phone:435-559-4717
Mailing Address - Fax:
Practice Address - Street 1:1189 E 700 S
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4022
Practice Address - Country:US
Practice Address - Phone:435-559-4717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10109980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist