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General NPI Number Information
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NPI Number | 1013110139
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Entity Type | Individual
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Provider Name | HARVELYN DUNCAN SMITH P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1250 HIGHWAY 54 W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4545
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Country | US
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Telephone | 770-719-7290
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Fax |
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Provider Business Mailing Address
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Address Line | 412 MAZLEY DR
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City | LOCUST GROVE
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State | GA
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Zip | 30248-7027
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Country | US
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Telephone | 770-914-7727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 001336
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License Number State | GA
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