MEDICARE: SMITHA JAMES RPT

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	PT008932	GA

General Provider Information

NPI Number	:	1538488374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SMITHA JAMES RPT

Provider Business Mailing Address
First Line	:	2714 STILLWATER LAKE LN
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-7906
Country	:	US
Telephone Number	:	770-509-9895
Fax Number	:

Provider Business Practice Location Address
First Line	:	2714 STILLWATER LAKE LN
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-7906
Country	:	US
Telephone Number	:	770-509-9895
Fax Number	:

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

Provider Enumeration Date	:	05/19/2010
Last Update Date	:	05/19/2010

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Directions to “ SMITHA JAMES RPT” Practice Location

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