Individual
GINNIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1211 HAWAII AVE, ALAMOGORDO, NM 88310-6437
(505) 439-3270
Mailing address
32 SOL DEL ORIENTE RD, ALAMOGORDO, NM 88310-9492
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2148
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79339
—
NM
Enumeration date
08/31/2006
Last updated
07/08/2007
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