MEDICARE: MR. CAMERON EDWARD SMITH PHYSICAL THERAPIST

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
1	225100000X	Physical Therapist	0575	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699747741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CAMERON EDWARD SMITH PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	10785 W TWAIN AVE STE 223
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3028
Country	:	US
Telephone Number	:	725-726-7847
Fax Number	:	725-726-7876

Provider Business Practice Location Address
First Line	:	2820 W CHARLESTON BLVD STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1942
Country	:	US
Telephone Number	:	725-726-7847
Fax Number	:	725-726-7876

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	09/16/2024

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