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NPI Code Detail

MEDICARE: KIMBERLY M SMITH MPT

MEDICARE: KIMBERLY M SMITH MPT
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 Therapist4779SC
2225100000XPhysical Therapist20778MD

General Provider Information

NPI Number : 1851475693
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY M SMITH MPT
Provider Business Mailing Address
First Line : 12158 CENTRAL AVE STE 113
Second Line :
City : MITCHELLVILLE
State : MD
Zip : 20721-1932
Country : US
Telephone Number : 301-390-3076
Fax Number : 301-390-3725
Provider Business Practice Location Address
First Line : 12158 CENTRAL AVE
Second Line :
City : MITCHELLVILLE
State : MD
Zip : 20721-1932
Country : US
Telephone Number : 301-390-3076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 01/10/2024

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Directions to “ KIMBERLY M SMITH MPT” Practice Location

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