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General NPI Number Information
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NPI Number | 1942321823
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Entity Type | Individual
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Provider Name | CARMEN ILENE SMITH PT
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 6165 LEHMAN DR SUITE 102
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-3441
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Country | US
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Telephone | 719-264-8524
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Fax | 719-264-8526
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Provider Business Mailing Address
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Address Line | 6165 LEHMAN DR STE 106
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-5405
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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 | 2115
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License Number State | CO
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