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General NPI Number Information
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NPI Number | 1285893859
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Entity Type | Organization
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Legal Business Name | WALK BY FAITH THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 06/08/2008
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Last Update Date | 06/08/2008
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Provider Practice Location Address
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Address Line | 3655 WATERWHEEL SQ
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2608
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Country | US
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Telephone | 443-858-8947
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Fax | 410-521-4904
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Provider Business Mailing Address
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Address Line | 3655 WATERWHEEL SQ
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2608
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Country | US
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Telephone | 443-858-8947
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Fax | 410-521-4904
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER
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Name | CLAIRE E SMITH
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Credential | P.T.
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Telephone | 443-858-8947
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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 | 17080
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License Number State | MD
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