Individual
ERIS W. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1600 2ND AVE SW, SUITE 24, MINOT, ND 58701-3459
(701) 839-4102
(701) 838-9603
Mailing address
2305 19TH AVE NW, MINOT, ND 58703-1649
(701) 839-4102
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
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