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Individual

DR. LUCAS DANIEL BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1406 W MAIN ST, RIVERTON, WY 82501-3239
(307) 857-7074
(307) 856-6459
Mailing address
1406 W MAIN ST, RIVERTON, WY 82501-3239
(307) 857-7074
(307) 856-6459

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
044522
NY
225100000X
Physical Therapist
Primary
PT1932
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT1932
STATE ISSUED PHYSICAL THERAPY LICENSE
WY
Enumeration date
11/07/2019
Last updated
03/05/2026
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