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NPI Code Detail

MEDICARE: VINCENT SMITH P.T.

MEDICARE: VINCENT SMITH P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist3466OH

General Provider Information

NPI Number : 1033212352
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCENT SMITH P.T.
Provider Business Mailing Address
First Line : PO BOX 273
Second Line : 8745 BLACKBIRD LANE
City : THORNVILLE
State : OH
Zip : 43076-0273
Country : US
Telephone Number : 740-246-5843
Fax Number : 740-246-6480
Provider Business Practice Location Address
First Line : 8745 BLACKBIRD LN
Second Line :
City : THORNVILLE
State : OH
Zip : 43076-9515
Country : US
Telephone Number : 740-246-5843
Fax Number : 740-246-6480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 07/09/2007

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Directions to “ VINCENT SMITH P.T.” Practice Location

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