Doctor Name: | LORI BENNETT |
NPI Number: | 1538301486 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 16050 |
Business Practice Address: | 3179 Braverton Street Suite 201 Edgewater, MD - 21037 |
Business Phone Number: | 4109564308 |
Business Fax Number: | |
Mailing Address: | 202 Coursevall Drive, Suite 111 & 112 CENTREVILLE |
State: | MD |
Postal Code: | 21617 |
Phone Number: | 4107580018 |
Fax Number: | |
NPI Enumeration Date: | 03/24/2009 |
NPI Last Update Date: | 03/24/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 16050 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |