Individual
ADELE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT ATC
Contact information
Practice address
77 MASSACHUSETTS AVE, E23-395, CAMBRIDGE, MA 02139-4301
(617) 253-0556
Mailing address
PO BOX 425789, E23, CAMBRIDGE, MA 02142-0015
(617) 253-0556
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3058
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y68212
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/29/2006
Last updated
07/08/2007
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