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General NPI Number Information
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NPI Number | 1154295731
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Entity Type | Individual
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Provider Name | BRANDY SMITH
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Gender | Female
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 202 3RD LOOP RD
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City | FLORENCE
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State | SC
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Zip | 29505-3795
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Country | US
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Telephone | 843-730-3901
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Fax |
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Provider Business Mailing Address
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Address Line | 6650 RIVERS AVE STE 105
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4829
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Country | US
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Telephone |
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | SC
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