Individual
MISS LORI L BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
7920 MOUNTAIN RD NE, ALBUQUERQUE PHYSICAL THERAPISTS, ALBUQUERQUE, NM 87110-7805
(505) 888-7979
(505) 888-8859
Mailing address
522 HERMOSA DR SE, ALBUQUERQUE, NM 87108
(505) 268-9209
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
705
NM
2251X0800X
Orthopedic Physical Therapist
705
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Q017
BCBS
NM
Enumeration date
11/22/2006
Last updated
11/19/2010
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