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General NPI Number Information
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NPI Number | 1720742190
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Entity Type | Individual
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Provider Name | SUNSHINE SMITH LMT, CPT
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Gender | Female
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Dates
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Enumeration Date | 10/22/2021
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 9309 OLDE 8 RD
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City | NORTHFIELD
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State | OH
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Zip | 44067-2060
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Country | US
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Telephone | 801-226-0360
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Fax |
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Provider Business Mailing Address
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Address Line | 5470 BRAINARD RD
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City | SOLON
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State | OH
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Zip | 44139-1110
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Country | US
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Telephone | 801-226-0360
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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 | 33.024245
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License Number State | OH
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