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NPI Code Detail

MEDICARE: MS. AMY LYNN SMITH PTA

MEDICARE: MS. AMY LYNN 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 Assistant160.008020IL
2225200000XPhysical Therapy AssistantPTP-PTA-LIC-13106MT

General Provider Information

NPI Number : 1790259505
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY LYNN SMITH PTA
Provider Business Mailing Address
First Line : 1815 ALDERSON AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-4015
Country : US
Telephone Number : 815-592-0522
Fax Number :
Provider Business Practice Location Address
First Line : 2115 CENTRAL AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-4741
Country : US
Telephone Number : 406-656-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2019
Last Update Date : 01/15/2019

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