Individual
BRADLEY A. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT,SCS,ATC
Contact information
Practice address
117 WESLEY CIR, NOBLESVILLE, IN 46062-9077
(317) 679-2809
(317) 877-0320
Mailing address
117 WESLEY CIR, NOBLESVILLE, IN 46062-9077
(317) 679-2809
(317) 877-0320
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001715A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000502221
ANTHEM BCBS PROVIDER NUMB
IN
01
—
DB9030
RAILROAD MEDICARE GROUP
GA
01
—
P00479059
RAILROAD PTAN
GA
Enumeration date
09/02/2006
Last updated
10/07/2008
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