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NPI Code Detail

MEDICARE: TABITHA ANNE SMITH PTA

MEDICARE: TABITHA ANNE SMITH PTA
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
1225200000XPhysical Therapy AssistantTEI000717PA

General Provider Information

NPI Number : 1265612386
Entity Type Code : Individual
Provider Name (Legal Business Name) : TABITHA ANNE SMITH PTA
Provider Business Mailing Address
First Line : 4 EISENHART DR
Second Line :
City : ABBOTTSTOWN
State : PA
Zip : 17301-9057
Country : US
Telephone Number : 717-259-7683
Fax Number :
Provider Business Practice Location Address
First Line : 2990 CARLISLE PIKE
Second Line :
City : NEW OXFORD
State : PA
Zip : 17350-9582
Country : US
Telephone Number : 717-624-2161
Fax Number : 717-624-5252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2007
Last Update Date : 05/10/2016

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