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NPI Code Detail

MEDICARE: MS. DIANE K SMITH LPT

MEDICARE:  MS. DIANE K SMITH  LPT
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
1225100000XPhysical Therapist6591OH
2101Y00000XCounselor

Other Identifiers

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

General Provider Information

NPI Number : 1568400422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE K SMITH LPT
Provider Business Mailing Address
First Line : 111 W WATER ST
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-2452
Country : US
Telephone Number : 740-851-4432
Fax Number : 740-851-4712
Provider Business Practice Location Address
First Line : 111 W WATER ST
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-2452
Country : US
Telephone Number : 740-851-4432
Fax Number : 740-851-4712
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2006
Last Update Date : 11/01/2018

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Directions to “ MS. DIANE K SMITH LPT” Practice Location

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