Individual
MATTHEW LEE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3915 GOLDEN VALLEY RD, MINNEAPOLIS, MN 55422-4249
(612) 775-2499
Mailing address
10845 69TH AVE N, MAPLE GROVE, MN 55369-5520
(763) 370-9081
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
MN
2251G0304X
Geriatric Physical Therapist
—
MN
2251X0800X
Orthopedic Physical Therapist
—
MN
Other
Enumeration date
05/19/2017
Last updated
03/17/2018
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