Healthcare Provider Details

I. General information

NPI: 1326970385
Provider Name (Legal Business Name): JEANNE MARIE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 CLEVELAND AVE
COLUMBUS OH
43231-2256
US

IV. Provider business mailing address

7110 SANDERS WAY
WESTERVILLE OH
43082-8022
US

V. Phone/Fax

Practice location:
  • Phone: 614-895-1090
  • Fax:
Mailing address:
  • Phone: 614-787-0671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA014299
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: