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General NPI Number Information
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NPI Number | 1578670352
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Entity Type | Individual
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Provider Name | SHARON LEE SMITH LPT
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1900 E MAIN ST
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City | DANVILLE
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State | IL
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Zip | 61832-5100
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Country | US
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Telephone | 217-554-5235
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Fax |
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Provider Business Mailing Address
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Address Line | 14133 N 920 EAST RD
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City | FAIRMOUNT
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State | IL
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Zip | 61841-6343
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Country | US
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Telephone | 217-427-2410
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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 |
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License Number State | IL
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