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General NPI Number Information
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NPI Number | 1134122534
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Entity Type | Organization
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Legal Business Name | CINDY L. SMITH
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 8121 S WESTERN AVE STE I
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-2546
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Country | US
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Telephone | 405-366-0184
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Fax | 405-604-6818
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Provider Business Mailing Address
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Address Line | 8121 S WESTERN AVE STE I
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-2546
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Country | US
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Telephone | 405-366-0184
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Fax | 405-604-6818
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Authorized Official
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Title or Position | OWNER
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Name | MS. CINDY L SMITH
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Credential | L.O., L.PED
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Telephone | 405-366-0184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | LO 20,LPED 27, LPO47
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License Number State | OK
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