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NPI Code Detail

MEDICARE: MRS. ANNE CHESTNUT SMITH OTR L

MEDICARE: MRS. ANNE CHESTNUT SMITH OTR L
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
1225X00000XOccupational Therapist442SC

General Provider Information

NPI Number : 1558458497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANNE CHESTNUT SMITH OTR L
Provider Business Mailing Address
First Line : 550 LIVE OAK CT
Second Line :
City : GREER
State : SC
Zip : 29651-7407
Country : US
Telephone Number : 864-476-8109
Fax Number :
Provider Business Practice Location Address
First Line : 850 E BUTLER RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29607-5842
Country : US
Telephone Number : 864-675-6421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/08/2007

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