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Individual

AUDRA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICAL THERAPIST

Contact information

Practice address
17904 GEORGIA AVENUE, SUITE 215, OLNEY, MD 20832
(301) 232-1050
(301) 232-1044
Mailing address
17904 GEORGIA AVENUE, SUITE 215, OLNEY, MD 20832
(301) 232-1050
(310) 232-1044

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
20269
MD
2251X0800X
Orthopedic Physical Therapist
Primary
20269
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20269
LICENCE
MD
Enumeration date
07/07/2005
Last updated
10/07/2013
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