MEDICARE: REINA SMITH PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	7621	OH

General Provider Information

NPI Number	:	1033216452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REINA SMITH PT

Provider Business Mailing Address
First Line	:	17411 CLIFTON BLVD
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-2211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 TOWN CENTRE DR
Second Line	:	SUITE 400
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-4008
Country	:	US
Telephone Number	:	440-526-8566
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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Directions to “ REINA SMITH PT” Practice Location

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