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General NPI Number Information
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NPI Number | 1255025896
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Entity Type | Individual
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Provider Name | MARSHALL LEE SMITH PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 14945 E LIMESTONE RD STE B
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City | HARVEST
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State | AL
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Zip | 35749-7394
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Country | US
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Telephone | 256-998-5102
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Fax | 256-998-5046
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Provider Business Mailing Address
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Address Line | 1200 CORPORATE DR STE 400
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City | HOOVER
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State | AL
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Zip | 35242-5424
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Country | US
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Telephone | 423-238-7217
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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 | 2-1257
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH11514
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License Number State | AL
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