Individual
LORI BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3179 BRAVERTON STREET, SUITE 201, EDGEWATER, MD 21037
(410) 956-4308
Mailing address
202 COURSEVALL DRIVE, SUITE 111 & 112, CENTREVILLE, MD 21617
(410) 758-0018
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16050
MD
Other
Enumeration date
03/24/2009
Last updated
03/24/2009
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