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General NPI Number Information
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NPI Number | 1659905966
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Entity Type | Individual
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Provider Name | ANNE R SMYTH LMT
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Gender | Female
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Dates
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Enumeration Date | 02/25/2020
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 6 W MAIN ST
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City | MARCELLUS
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State | NY
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Zip | 13108-1118
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Country | US
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Telephone | 315-559-2748
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Fax |
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Provider Business Mailing Address
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Address Line | 1778 LEDYARD RD
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City | KING FERRY
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State | NY
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Zip | 13081-9705
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Country | US
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Telephone | 607-379-0441
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 029544
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License Number State | NY
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