MEDICARE: BENDAVID CLINIC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath

General Provider Information

NPI Number	:	1700649761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENDAVID CLINIC PLLC

Provider Business Mailing Address
First Line	:	305 SAINT PAUL ST STE 324
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-9826
Country	:	US
Telephone Number	:	802-881-0424
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 SAINT PAUL ST
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-5073
Country	:	US
Telephone Number	:	802-578-0551
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JACQUELYN BURRELL
Credential	:	ND
Telephone Number	:	802-578-0551

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	09/29/2025

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