Healthcare Provider Details

I. General information

NPI: 1386608701
Provider Name (Legal Business Name): ERIN SMITHLEY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 ROUTE 286
PITTSBURGH PA
15239-2839
US

IV. Provider business mailing address

366 PRINCETON DR
PITTSBURGH PA
15235-4841
US

V. Phone/Fax

Practice location:
  • Phone: 724-325-1270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTE002580L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: