Individual
ERIS W. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
641
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20742
BLUE CROSS/BLUE SHIELD
ND
01
—
450461512000
WORKFORCE SAFETY INSURANC
ND
05
—
52828
—
ND
01
—
P00296963001
RAILROAD MEDICARE
ND
Enumeration date
08/31/2006
Last updated
07/08/2007
Update your record
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