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General NPI Number Information
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NPI Number | 1922586866
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Entity Type | Individual
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Provider Name | SAVANNAH SMITH PT,DPT
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Gender | Female
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Dates
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Enumeration Date | 08/02/2018
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Last Update Date | 08/02/2018
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Provider Practice Location Address
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Address Line | 17183 INTERSTATE 45 S
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City | SHENANDOAH
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State | TX
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Zip | 77385-3312
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Country | US
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Telephone | 936-270-4670
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Fax |
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Provider Business Mailing Address
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Address Line | 7512 27TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34209-5341
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Country | US
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Telephone |
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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 | 1294287
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License Number State | TX
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