Individual
MR. LEE C BENNETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
10 HIGH ST, S. C. ORTHO - SUITE G, WAKEFIELD, RI 02879-3144
(401) 783-8077
(401) 789-6029
Mailing address
43 CRESTWOOD DR, HOPE VALLEY, RI 02832-3405
(207) 577-4891
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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