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General NPI Number Information
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NPI Number | 1699420554
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Entity Type | Individual
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Provider Name | WILLIAM JAMES SMITH PT, DPT, OCS, CSCS
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Gender | Male
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Dates
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Enumeration Date | 02/18/2022
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Last Update Date | 02/18/2022
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Provider Practice Location Address
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Address Line | 1972 ORMOND BLVD
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City | DESTREHAN
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State | LA
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Zip | 70047-3818
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Country | US
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Telephone | 985-307-0925
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Fax |
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Provider Business Mailing Address
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Address Line | 1532 SAINT ANDREW ST APT 302
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City | NEW ORLEANS
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State | LA
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Zip | 70130-5352
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Country | US
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Telephone | 504-256-4251
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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 | 09948
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License Number State | LA
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