Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2801 | CO |
N | 111NI0900X | Internist | 2801 | CO |
N | 111NN1001X | Nutrition | 2801 | CO |
N | 111NR0400X | Rehabilitation Chiropractor | 2801 | CO |
NPI | 1639375710 |
---|---|
Provider Name | Dr. Lorrie Van Bennett |
First Address | Glenwood Springs, CO 81601-3032 |
Second Address | Glenwood Springs, CO 81601-3032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 08/07/2007 |