Individual
PEGGY A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.P.T.
Contact information
Practice address
520 N CANYON ST, SPEARFISH, SD 57783-2320
(605) 642-7996
(605) 642-5955
Mailing address
520 N CANYON ST, SPEARFISH, SD 57783-2320
(605) 642-7996
(605) 642-5955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0336
SD
225100000X
Physical Therapist
2110
AZ
225100000X
Physical Therapist
336
WY
225100000X
Physical Therapist
806
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275727745
—
WY
01
—
4992796
BLUE CROSS BLUE SHIELD
SD
05
—
5836230
—
SD
Enumeration date
08/28/2007
Last updated
08/28/2008
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