Individual
JENNIFER H SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1006 BROAD STREET, ORIENTAL, NC 28571-0769
(252) 249-1869
(252) 249-0112
Mailing address
PO BOX 894, ORIENTAL, NC 28571-0769
(252) 249-1869
(252) 249-0112
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4279
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078AZ
BCBS
NC
05
—
7211378
—
NC
Enumeration date
02/08/2006
Last updated
05/17/2010
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