Provider Demographics
NPI:1689156606
Name:BENSON, LORI (MSPT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-2010
Mailing Address - Country:US
Mailing Address - Phone:406-283-7280
Mailing Address - Fax:406-293-4932
Practice Address - Street 1:1029 MT HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:NOXON
Practice Address - State:MT
Practice Address - Zip Code:59853-9746
Practice Address - Country:US
Practice Address - Phone:406-847-7325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1686225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist