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Individual
MR. LEE C BENNETT III
Active
Individual
MR. LEE C BENNETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01935
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412031
RI BLUE CHIP PIN
RI
Enumeration date
07/25/2006
Last updated
07/09/2007
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