Healthcare Provider Details

I. General information

NPI: 1942895008
Provider Name (Legal Business Name): ALLISON R SMITH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2021
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 W SPROUL RD
SPRINGFIELD PA
19064-2027
US

IV. Provider business mailing address

3608 WILLIAMSON AVE
BROOKHAVEN PA
19015-2821
US

V. Phone/Fax

Practice location:
  • Phone: 610-328-8800
  • Fax: 610-328-8792
Mailing address:
  • Phone: 908-917-0224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022486
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: