Individual
EDWARD B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012887
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00333051
RAILROAD MEDICARE
MI
Enumeration date
07/13/2006
Last updated
12/05/2008
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