Individual
MRS. BETTY MAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3676
(605) 385-3329
Mailing address
14410 TATUM COURT, RAPID CITY, SD 57701
(605) 343-0543
(605) 385-3329
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1141
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1141
PHYSICAL THERAPY LICENSE
AZ
Enumeration date
01/26/2006
Last updated
07/08/2007
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