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NPI Code Detail

MEDICARE: MRS. CARRIE ANN SMITH P.T.

MEDICARE: MRS. CARRIE ANN 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 Therapist05009255AIN

General Provider Information

NPI Number : 1194040238
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE ANN SMITH P.T.
Provider Business Mailing Address
First Line : 5725 N COUNTY ROAD 775 W
Second Line :
City : WEST BADEN SPRINGS
State : IN
Zip : 47469-9308
Country : US
Telephone Number : 812-936-7258
Fax Number :
Provider Business Practice Location Address
First Line : 5725 N COUNTY ROAD 775 W
Second Line :
City : WEST BADEN SPRINGS
State : IN
Zip : 47469-9308
Country : US
Telephone Number : 812-936-7258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2010
Last Update Date : 04/01/2010

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Directions to “ MRS. CARRIE ANN SMITH P.T.” Practice Location

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