Individual
ANNETTE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10574 GREENBELT DR, CLIVE, IA 50325-6617
(515) 520-8037
Mailing address
10574 GREENBELT DR, CLIVE, IA 50325-6617
(515) 473-4725
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097288
IA LICENSE
IA
Enumeration date
08/09/2019
Last updated
11/08/2023
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