MEDICARE: BRITTNEY SMITH LMT

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	225700000X	Massage Therapist	175081	OK
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1093140899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY SMITH LMT

Provider Business Mailing Address
First Line	:	1002 SW 89TH ST APT 1216
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9458
Country	:	US
Telephone Number	:	405-234-7047
Fax Number	:

Provider Business Practice Location Address
First Line	:	1002 SW 89TH ST APT 1216
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-9458
Country	:	US
Telephone Number	:	405-234-7047
Fax Number	:

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

Provider Enumeration Date	:	09/11/2013
Last Update Date	:	11/18/2020

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