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NPI Code Detail

MEDICARE: REBECCA LYNNE SMILIE P.T.

MEDICARE: REBECCA LYNNE SMILIE 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 Therapist00657LA

General Provider Information

NPI Number : 1669775805
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA LYNNE SMILIE P.T.
Provider Business Mailing Address
First Line : 3704 NORTH BLVD STE C
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3658
Country : US
Telephone Number : 318-473-2230
Fax Number : 318-449-5579
Provider Business Practice Location Address
First Line : 3704 NORTH BLVD STE C
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-3658
Country : US
Telephone Number : 318-473-2230
Fax Number : 318-449-5579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2010
Last Update Date : 12/09/2010

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Directions to “ REBECCA LYNNE SMILIE P.T.” Practice Location

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