MEDICARE: MRS. ANGELA ANN SMITH OTR-L

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	225X00000X	Occupational Therapist	5638	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477686723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA ANN SMITH OTR-L

Provider Business Mailing Address
First Line	:	4071 OAK HOLLOW DR
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-4782
Country	:	US
Telephone Number	:	828-448-1561
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 MORGANTON BLVD SW
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5677
Country	:	US
Telephone Number	:	828-757-6226
Fax Number	:	828-757-6289

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	09/12/2016

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